From the Guidelines
Unilateral putamen abnormality on DaTscan is more indicative of early Parkinson's disease, while bilateral abnormalities suggest more advanced disease or other parkinsonian disorders. When evaluating DaTscan results, it's crucial to consider the pattern of putamen involvement, as this can provide valuable insights into the underlying pathology. According to the American College of Radiology Appropriateness Criteria for movement disorders and neurodegenerative diseases 1, the pattern of abnormality can help differentiate between various conditions. Key points to consider include:
- Unilateral putamen abnormality often correlates with early Parkinson's disease or other parkinsonian syndromes
- Bilateral putamen abnormalities generally indicate more advanced disease or other parkinsonian disorders like Multiple System Atrophy or Progressive Supranuclear Palsy
- Dopaminergic degeneration in Parkinson's disease usually begins asymmetrically, affecting one putamen before progressing to involve both sides
- The distinction between unilateral and bilateral abnormalities is clinically relevant, as it can inform disease staging and guide management decisions In clinical practice, interpreting DaTscan findings in conjunction with the patient's clinical presentation is essential, as the imaging alone cannot definitively distinguish between different parkinsonian disorders, only confirm the presence of a dopaminergic deficit 1.
From the Research
Unilateral vs Bilateral Putamen Abnormality on DaTscan
- The studies provided do not directly address the topic of unilateral vs bilateral putamen abnormality on DaTscan 2, 3, 4, 5, 6.
- However, the study by 3 discusses the use of DaTscan in differential diagnosis of dopa-responsive dystonia and young-onset Parkinson's disease, and mentions that ten out of 11 patients with young-onset Parkinson's disease had decreased accumulation of DaTSCAN in striatum, especially in putamen.
- The study does not specifically mention unilateral or bilateral putamen abnormality, but suggests that putamen abnormality is a common finding in Parkinson's disease.
- Another study by 2 mentions that DaTscan imaging can be useful in determining if nigrostriatal dopaminergic degeneration is present, but does not provide information on unilateral vs bilateral putamen abnormality.
- There is no direct evidence in the provided studies to support a conclusion on unilateral vs bilateral putamen abnormality on DaTscan.
Clinical Implications
- The diagnosis of Parkinson's disease is primarily clinical, but DaTscan imaging can be helpful in cases of diagnostic uncertainty 2.
- DaTscan imaging can be useful in several clinical scenarios, including in patients with early subtle symptoms, suboptimal response to levodopa, and prominent action tremor 2.
- The use of DaTscan imaging can lead to changes in clinical diagnosis and treatment plans 2.
Limitations
- The provided studies do not directly address the topic of unilateral vs bilateral putamen abnormality on DaTscan.
- More research is needed to fully understand the implications of unilateral vs bilateral putamen abnormality on DaTscan in the diagnosis and treatment of Parkinson's disease.