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This study aimed to compare the specificity and sensitivity of brain MRI volumetry and dopamine transporter scans in differentiating PD from other extrapyramidal syndromes in the early stages of the disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>This study included 34 patients younger than 70 years old with less than 3 years of extrapyramidal symptoms. Demographic and clinical history of the patients, including age, sex, and disease duration, was gathered. Disease severity was assessed using Unified Parkinson's Disease Rating Scale III (UPDRS III). For all patients, <jats:sup>99m<\/jats:sup>Tc\u2010TRODAT single\u2010photon emission computed tomography (SPECT) and MRI volumetry were performed. Patients were followed up for 1 year and examined for final diagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>According to the quantitative <jats:sup>99m<\/jats:sup>Tc\u2010TRODAT analysis, all of the specific binding ratio (SBR) parameters, including right, left, and bilateral SBRs, were significantly higher in the non\u2010Parkinsonian patients. Also, the results indicated a high diagnostic accuracy for both quantitative <jats:sup>99m<\/jats:sup>Tc\u2010TRODAT analysis (about 88% for SBR parameters) and MRI volumetry (71% for bilateral olfactory bulbs volume) in diagnosing PD. Regarding the diagnosis of PD, there were no significant differences between quantitative scan results and olfactory bulb volumetry according to the area under the receiver operating characteristic curves.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSION<\/jats:title><jats:p><jats:sup>99m<\/jats:sup>Tc\u2010TRODAT has a higher accuracy in differentiation of early PD from non\u2010Parkinsonian conditions, particularly essential tremor. Olfactory bulbs volumetry by using MRI can also serve as a potential alternative method in this regard.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jon.12740","type":"journal-article","created":{"date-parts":[[2020,6,18]],"date-time":"2020-06-18T04:03:31Z","timestamp":1592453011000},"page":"683-689","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Brain TRODAT\u2010SPECT Versus MRI Morphometry in Distinguishing Early Mild Parkinson's Disease from Other Extrapyramidal Syndromes"],"prefix":"10.1111","volume":"30","author":[{"given":"Mohammad Reza","family":"Hossein\u2010Tehrani","sequence":"first","affiliation":[{"name":"Clinical Neurology Research Center Shiraz University of Medical Sciences  Shiraz Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1216-6609","authenticated-orcid":false,"given":"Tahereh","family":"Ghaedian","sequence":"additional","affiliation":[{"name":"Nuclear Medicine and Molecular Imaging Research Center, Namazi Teaching Hospital Shiraz University of Medical Sciences  Shiraz Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Etrat","family":"Hooshmandi","sequence":"additional","affiliation":[{"name":"Clinical Neurology Research Center Shiraz University of Medical Sciences  Shiraz Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leila","family":"Kalhor","sequence":"additional","affiliation":[{"name":"Nuclear Medicine and Molecular Imaging Research Center, Namazi Teaching Hospital Shiraz University of Medical Sciences  Shiraz Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amin Abolhasani","family":"Foroughi","sequence":"additional","affiliation":[{"name":"Medical Imaging Research Center Shiraz University of Medical Sciences  Shiraz Iran"},{"name":"Epilepsy Research Center Shiraz University of Medical Sciences  Shiraz Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2407-5915","authenticated-orcid":false,"given":"Vahid Reza","family":"Ostovan","sequence":"additional","affiliation":[{"name":"Clinical Neurology Research Center Shiraz University of Medical Sciences  Shiraz Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,6,17]]},"reference":[{"key":"e_1_2_5_2_1","first-page":"504","article-title":"Parkinson's disease and its management: part 1: disease entity, risk factors, pathophysiology, clinical presentation, and diagnosis","volume":"40","author":"DeMaagd G","year":"2015","journal-title":"P T"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arr.2014.01.004"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0720-048X(03)00214-6"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.2008.157370"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.2967\/jnmt.112.111617"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/412486"},{"key":"e_1_2_5_8_1","first-page":"22","article-title":"Dopamine transporter imaging with Tc\u201099m TRODAT\u20101 SPECT in Parkinson's disease and its correlation with clinical disease severity","volume":"7","author":"Patel A","year":"2019","journal-title":"Asia Ocean J Nucl Med Biol"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/archneurol.2009.217"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1159\/000381708"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1159\/000154933"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.21584"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.22005"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.2008.147223"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1353-8020(11)70029-3"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1586\/ern.12.49"},{"key":"e_1_2_5_17_1","doi-asserted-by":"crossref","first-page":"589","DOI":"10.5334\/tohm.441","article-title":"Essential tremor and Parkinson's disease: exploring the relationship","volume":"8","author":"Tarakad A","year":"2019","journal-title":"Tremor Other Hyperkinet Mov (N Y)"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.1159\/000314495"},{"key":"e_1_2_5_19_1","unstructured":"ElshafeyRA EltomeyMA FaedH et\u00a0al.Volumetric brain MRI changes in Parkinson's disease. 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