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<meta name="DC.Description" content="SUMMARY: As we defeat infectious diseases and cancer, one of the greatest medical challenges facing us in the mid-21st century will be the increasing prevalence of degenerative disease. Those diseases, which affect movement and cognition, can be the most debilitating. Dysfunction of the extrapyramidal system results in increasing motor disability often manifest as tremor, bradykinesia, and rigidity. The common pathologic pathway of these diseases, collectively described as parkinsonian syndromes, such as Parkinson disease, multiple system atrophy, progressive supranuclear palsy, corticobasal degeneration, and dementia with Lewy bodies, is degeneration of the presynaptic dopaminergic pathways in the basal ganglia. Conventional MR imaging is insensitive, especially in early disease, so functional imaging has become the primary method used to differentiate a true parkinsonian syndrome from vascular parkinsonism, drug-induced changes, or essential tremor. Unusually for a modern functional imaging technique, the method most widely used in European clinics depends on SPECT and not PET. This SPECT technique (described in the first of 2 parts) commonly reports dopamine-transporter function, with decreasing striatal uptake demonstrating increasingly severe disease.

### Abbreviations

DaT
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18F
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123I
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&lt;p&gt;As we defeat infectious diseases and cancer, one of the greatest medical challenges facing us in the mid-21st century will be the increasing prevalence of degenerative disease. Those diseases, which affect movement and cognition, can be the most debilitating. Dysfunction of the extrapyramidal system results in increasing motor disability often manifest as tremor, bradykinesia, and rigidity. The common pathologic pathway of these diseases, collectively described as parkinsonian syndromes, such as Parkinson disease, multiple system atrophy, progressive supranuclear palsy, corticobasal degeneration, and dementia with Lewy bodies, is degeneration of the presynaptic dopaminergic pathways in the basal ganglia. Conventional MR imaging is insensitive, especially in early disease, so functional imaging has become the primary method used to differentiate a true parkinsonian syndrome from vascular parkinsonism, drug-induced changes, or essential tremor. Unusually for a modern functional imaging technique, the method most widely used in European clinics depends on SPECT and not PET. This SPECT technique (described in the first of 2 parts) commonly reports dopamine-transporter function, with decreasing striatal uptake demonstrating increasingly severe disease.&lt;/p&gt;" />
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<meta name="twitter:description" content="SUMMARY: As we defeat infectious diseases and cancer, one of the greatest medical challenges facing us in the mid-21st century will be the increasing prevalence of degenerative disease. Those diseases, which affect movement and cognition, can be the most debilitating. Dysfunction of the extrapyramidal system results in increasing motor disability often manifest as tremor, bradykinesia, and rigidity. The common pathologic pathway of these diseases, collectively described as parkinsonian syndromes, such as Parkinson disease, multiple system atrophy, progressive supranuclear palsy, corticobasal degeneration, and dementia with Lewy bodies, is degeneration of the presynaptic dopaminergic pathways in the basal ganglia. Conventional MR imaging is insensitive, especially in early disease, so functional imaging has become the primary method used to differentiate a true parkinsonian syndrome from vascular parkinsonism, drug-induced changes, or essential tremor. Unusually for a modern functional imaging technique, the method most widely used in European clinics depends on SPECT and not PET. This SPECT technique (described in the first of 2 parts) commonly reports dopamine-transporter function, with decreasing striatal uptake demonstrating increasingly severe disease.

### Abbreviations

DaT
:   dopamine transporters
18F
:   fluorine 18
18F-DOPA
:   6-[18F]fluoro-L-3,4-dihydroxyphenylalanine
123I
:   iodine 123
123I-FP-CIT
:   123I-ioflupane ( N -ω-fluoropropyl-β CIT)
PD
:   idiopathic Parkinson disease
SWEDD
:   scans without evidence of dopaminergic deficit" />
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<meta name="og-description" property="og:description" content="SUMMARY: As we defeat infectious diseases and cancer, one of the greatest medical challenges facing us in the mid-21st century will be the increasing prevalence of degenerative disease. Those diseases, which affect movement and cognition, can be the most debilitating. Dysfunction of the extrapyramidal system results in increasing motor disability often manifest as tremor, bradykinesia, and rigidity. The common pathologic pathway of these diseases, collectively described as parkinsonian syndromes, such as Parkinson disease, multiple system atrophy, progressive supranuclear palsy, corticobasal degeneration, and dementia with Lewy bodies, is degeneration of the presynaptic dopaminergic pathways in the basal ganglia. Conventional MR imaging is insensitive, especially in early disease, so functional imaging has become the primary method used to differentiate a true parkinsonian syndrome from vascular parkinsonism, drug-induced changes, or essential tremor. Unusually for a modern functional imaging technique, the method most widely used in European clinics depends on SPECT and not PET. This SPECT technique (described in the first of 2 parts) commonly reports dopamine-transporter function, with decreasing striatal uptake demonstrating increasingly severe disease.

### Abbreviations

DaT
:   dopamine transporters
18F
:   fluorine 18
18F-DOPA
:   6-[18F]fluoro-L-3,4-dihydroxyphenylalanine
123I
:   iodine 123
123I-FP-CIT
:   123I-ioflupane ( N -ω-fluoropropyl-β CIT)
PD
:   idiopathic Parkinson disease
SWEDD
:   scans without evidence of dopaminergic deficit" />
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      <h1 class="highwire-cite-title" id="page-title">The Role of Functional Dopamine-Transporter SPECT Imaging in Parkinsonian Syndromes, Part 1</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">T.C. Booth</span>, <span class="highwire-citation-author" data-delta="1">M. Nathan</span>, <span class="highwire-citation-author" data-delta="2">A.D. Waldman</span>, <span class="highwire-citation-author" data-delta="3">A.-M. Quigley</span>, <span class="highwire-citation-author" data-delta="4">A.H. Schapira</span> and <span class="highwire-citation-author" data-delta="5">J. Buscombe</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">June 2014,  </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A3970 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-50683--61821526751" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">T.C. Booth </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Department of Neuroradiology (T.C.B.), National Hospital for Neurology and Neurosurgery, London, UK; Department of Nuclear Medicine (M.N., A.-M.Q.), Royal Free Hospital National Health Service Trust, London, UK; Department of Imaging (A.D.W.), Imperial College Healthcare National Health Service Trust, London, UK; Department of Clinical Neurosciences (A.H.S.), Institute of Neurology, University College London, London, UK; and Department of Nuclear Medicine (J.B.), Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=T.C.%2BBooth%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Booth%20T&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AT.C.%2BBooth%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">M. Nathan </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Department of Neuroradiology (T.C.B.), National Hospital for Neurology and Neurosurgery, London, UK; Department of Nuclear Medicine (M.N., A.-M.Q.), Royal Free Hospital National Health Service Trust, London, UK; Department of Imaging (A.D.W.), Imperial College Healthcare National Health Service Trust, London, UK; Department of Clinical Neurosciences (A.H.S.), Institute of Neurology, University College London, London, UK; and Department of Nuclear Medicine (J.B.), Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=M.%2BNathan%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Nathan%20M&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AM.%2BNathan%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">A.D. Waldman </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Department of Neuroradiology (T.C.B.), National Hospital for Neurology and Neurosurgery, London, UK; Department of Nuclear Medicine (M.N., A.-M.Q.), Royal Free Hospital National Health Service Trust, London, UK; Department of Imaging (A.D.W.), Imperial College Healthcare National Health Service Trust, London, UK; Department of Clinical Neurosciences (A.H.S.), Institute of Neurology, University College London, London, UK; and Department of Nuclear Medicine (J.B.), Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=A.D.%2BWaldman%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Waldman%20A&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AA.D.%2BWaldman%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">A.-M. Quigley </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Department of Neuroradiology (T.C.B.), National Hospital for Neurology and Neurosurgery, London, UK; Department of Nuclear Medicine (M.N., A.-M.Q.), Royal Free Hospital National Health Service Trust, London, UK; Department of Imaging (A.D.W.), Imperial College Healthcare National Health Service Trust, London, UK; Department of Clinical Neurosciences (A.H.S.), Institute of Neurology, University College London, London, UK; and Department of Nuclear Medicine (J.B.), Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=A.-M.%2BQuigley%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Quigley%20A&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AA.-M.%2BQuigley%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">A.H. Schapira </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Department of Neuroradiology (T.C.B.), National Hospital for Neurology and Neurosurgery, London, UK; Department of Nuclear Medicine (M.N., A.-M.Q.), Royal Free Hospital National Health Service Trust, London, UK; Department of Imaging (A.D.W.), Imperial College Healthcare National Health Service Trust, London, UK; Department of Clinical Neurosciences (A.H.S.), Institute of Neurology, University College London, London, UK; and Department of Nuclear Medicine (J.B.), Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=A.H.%2BSchapira%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Schapira%20A&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AA.H.%2BSchapira%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-5"><div class="author-tooltip-name">J. Buscombe </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'>From the Department of Neuroradiology (T.C.B.), National Hospital for Neurology and Neurosurgery, London, UK; Department of Nuclear Medicine (M.N., A.-M.Q.), Royal Free Hospital National Health Service Trust, London, UK; Department of Imaging (A.D.W.), Imperial College Healthcare National Health Service Trust, London, UK; Department of Clinical Neurosciences (A.H.S.), Institute of Neurology, University College London, London, UK; and Department of Nuclear Medicine (J.B.), Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=J.%2BBuscombe%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Buscombe%20J&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AJ.%2BBuscombe%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div></div></div>  </div>

  
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    <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" class="content-block-markup" xmlns:xhtml="http://www.w3.org/1999/xhtml"><div xmlns:xhtml="http://www.w3.org/1999/xhtml" class="contributors"><ol class="contributor-list" id="contrib-group-1"><li class="contributor" id="contrib-1"><span class="name">T.C. Booth</span><a id="xref-aff-1-1" class="xref-aff" href="#aff-1"></a>, </li><li class="contributor" id="contrib-2"><span class="name">M. Nathan</span><a id="xref-aff-1-2" class="xref-aff" href="#aff-1"></a>, </li><li class="contributor" id="contrib-3"><span class="name">A.D. Waldman</span><a id="xref-aff-1-3" class="xref-aff" href="#aff-1"></a>, </li><li class="contributor" id="contrib-4"><span class="name">A.-M. Quigley</span><a id="xref-aff-1-4" class="xref-aff" href="#aff-1"></a>, </li><li class="contributor" id="contrib-5"><span class="name">A.H. Schapira</span><a id="xref-aff-1-5" class="xref-aff" href="#aff-1"></a> and </li><li class="last" id="contrib-6"><span class="name">J. Buscombe</span><a id="xref-aff-1-6" class="xref-aff" href="#aff-1"></a></li></ol><ol class="affiliation-list"><li class="aff"><a id="aff-1" name="aff-1"></a><address>From the Department of Neuroradiology (T.C.B.), National Hospital for Neurology and Neurosurgery, London, UK; Department of Nuclear Medicine (M.N., A.-M.Q.), Royal Free Hospital National Health Service Trust, London, UK; Department of Imaging (A.D.W.), Imperial College Healthcare National Health Service Trust, London, UK; Department of Clinical Neurosciences (A.H.S.), Institute of Neurology, University College London, London, UK; and Department of Nuclear Medicine (J.B.), Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.</address></li></ol><ol class="corresp-list"><li class="corresp" id="corresp-1">Please address correspondence to Thomas C. Booth, MA, MBBS, MRCP, FRCR, Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, Queen Square, London, WC1N 3BG, UK; e-mail: <span class="em-link"><span class="em-addr">tombooth{at}doctors.org.uk</span></span></li></ol></div></div></div>  </div>

  
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