{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T08:50:45Z","timestamp":1772527845929,"version":"3.50.1"},"reference-count":29,"publisher":"FapUNIFESP (SciELO)","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arq. Neuro-Psiquiatr."],"published-print":{"date-parts":[[2012,9]]},"abstract":"<jats:p>The clinical diagnosis of Parkinson's disease (PD) is susceptible to misdiagnosis, especially in the earlier stages of the disease. Recently, in vivo imaging techniques assessing the presynaptic dopamine transporter (DAT) have emerged as a useful tool in PD diagnosis, improving its accuracy. OBJECTIVE: It was to illustrate the clinical usefulness of a brain single-photon emission computed tomography (SPECT) DAT ligand, and highlight relevant aspects of scans without evidence of dopaminergic deficit (SWEDDs) in this context. CASES: We described four representative patients with clinically unclear parkinsonian syndromes who underwent [99mTc]-TRODAT-1 SPECT and reviewed the clinical implications. CONCLUSION: DAT-SPECT is an important, cost-effective, technique for the differential diagnosis of parkinsonian syndromes. Additionally, SWEDD cases present clinical and paraclinical peculiarities that may retrospectively identify them as essential\/dystonic tremor. The lack of histopathological data limits further conclusions.<\/jats:p>","DOI":"10.1590\/s0004-282x2012000900004","type":"journal-article","created":{"date-parts":[[2012,9,15]],"date-time":"2012-09-15T11:58:19Z","timestamp":1347710299000},"page":"667-673","source":"Crossref","is-referenced-by-count":20,"title":["Dopamine transporter imaging in clinically unclear cases of parkinsonism and the importance of Scans Without Evidence of Dopaminergic Deficit (SWEDDs)"],"prefix":"10.1590","volume":"70","author":[{"given":"Marco A. T.","family":"Utiumi","sequence":"first","affiliation":[{"name":"Universidade Federal do Paran\u00e1, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andr\u00e9 C.","family":"Fel\u00edcio","sequence":"additional","affiliation":[{"name":"Universidade Federal de S\u00e3o Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Conrado R.","family":"Borges","sequence":"additional","affiliation":[{"name":"Universidade Federal do Paran\u00e1, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vera L.","family":"Braatz","sequence":"additional","affiliation":[{"name":"Universidade Federal do Paran\u00e1, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sheyla A. S.","family":"Rezende","sequence":"additional","affiliation":[{"name":"Universidade Federal do Paran\u00e1, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Renato P.","family":"Munhoz","sequence":"additional","affiliation":[{"name":"Universidade Federal do Paran\u00e1, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rodrigo A.","family":"Bressan","sequence":"additional","affiliation":[{"name":"UNIFESP, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henrique B.","family":"Ferraz","sequence":"additional","affiliation":[{"name":"Universidade Federal de S\u00e3o Paulo, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H\u00e9lio A. G.","family":"Teive","sequence":"additional","affiliation":[{"name":"Universidade Federal do Paran\u00e1, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"530","reference":[{"key":"ref1","first-page":"467","article-title":"SIC Task Force appraisal of clinical diagnostic criteria for parkinsonian disorders","volume":"18","author":"Litvan I","year":"2003","journal-title":"Mov Disord","ISSN":"https:\/\/id.crossref.org\/issn\/0855-3185","issn-type":"print"},{"key":"ref2","series-title":"Parkinson's disease: National clinical guideline for diagnosis and management in primary and secondary care","year":"2006"},{"key":"ref3","series-title":"GeneReviews and GeneTests: Medical Genetics Information Resource","volume-title":"Parkinson disease overview","author":"Pankratz ND","year":"2011"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1016\/j.clineuro.2010.03.003","article-title":"The differential diagnoses of parkinsonism: findings from a cohort of 1528 patients and a 10 years comparison in tertiary movement disorders clinics","volume":"112","author":"Munhoz RP","year":"2010","journal-title":"Clin Neurol Neurosur"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"861","DOI":"10.1093\/brain\/awf080","article-title":"The accuracy of diagnosis of parkinsonian syndromes in a specialist movement disorder service","volume":"125","author":"Hughes AJ","year":"2002","journal-title":"Brain","ISSN":"https:\/\/id.crossref.org\/issn\/0006-8950","issn-type":"print"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1016\/S0197-4580(02)00065-9","article-title":"Staging of brain pathology related to sporadic Parkinson's disease","volume":"24","author":"Braak H","year":"2003","journal-title":"Neurobiol Aging","ISSN":"https:\/\/id.crossref.org\/issn\/0197-4580","issn-type":"print"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"596","DOI":"10.2967\/jnumed.108.059998","article-title":"Imaging approaches to Parkinson disease","volume":"51","author":"Brooks DJ","year":"2010","journal-title":"J Nucl Med","ISSN":"https:\/\/id.crossref.org\/issn\/0161-5505","issn-type":"print"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"1653","DOI":"10.1001\/jama.287.13.1653","article-title":"Dopamine transporter brain imaging to assess the effects of pramipexole vs levodopa on Parkinson disease progression","volume":"287","year":"2002","journal-title":"JAMA","ISSN":"https:\/\/id.crossref.org\/issn\/0098-7484","issn-type":"print"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1097\/00002826-200001000-00007","article-title":"A randomized controlled trial comparing pramipexole with levodopa in early Parkinson's disease: design and methods of the CALM-PD Study","volume":"23","year":"2000","journal-title":"Clin Neuropharmacol","ISSN":"https:\/\/id.crossref.org\/issn\/0362-5664","issn-type":"print"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1002\/ana.10609","article-title":"Slower progression of Parkinson's disease with ropinirole versus levodopa: the REAL-PET Study","volume":"54","author":"Whone AL","year":"2003","journal-title":"Ann Neurol","ISSN":"https:\/\/id.crossref.org\/issn\/0364-5134","issn-type":"print"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"2498","DOI":"10.1056\/NEJMoa033447","article-title":"Levodopa and the progression of Parkinson's disease","volume":"351","author":"Fahn S","year":"2004","journal-title":"N Engl J Med","ISSN":"https:\/\/id.crossref.org\/issn\/0028-4793","issn-type":"print"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"IV37","DOI":"10.1007\/s00415-005-4008-5","article-title":"Does levodopa slow or hasten the rate of progression of Parkinson's disease","volume":"252","author":"Fahn S","year":"2005","journal-title":"J Neurol","ISSN":"https:\/\/id.crossref.org\/issn\/0340-5354","issn-type":"print"},{"key":"ref13","first-page":"2210","article-title":"Patients with adult-onset dystonic tremor resembling parkinsonian tremor have scans without evidence od dopaminergic deficit (SWEDDs)","volume":"22","author":"Schneider SA","year":"2007","journal-title":"Mov Disord","ISSN":"https:\/\/id.crossref.org\/issn\/0855-3185","issn-type":"print"},{"key":"ref14","article-title":"Long-term follow-up of patients with scans without evidence of dopaminergic deficit (SWEDDs) in the ELLDOPA study","volume":"64","author":"Marek K","year":"2005","journal-title":"Neurology","ISSN":"https:\/\/id.crossref.org\/issn\/0028-3878","issn-type":"print"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"1443","DOI":"10.1212\/WNL.0b013e3181a18809","article-title":"Dystonic tremor presenting as parkinsonism: long-term follow-up of SWEDDs","volume":"72","author":"Bain PG","year":"2009","journal-title":"Neurology","ISSN":"https:\/\/id.crossref.org\/issn\/0028-3878","issn-type":"print"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"744","DOI":"10.1136\/jnnp.2009.172825","article-title":"Olfaction in patients with suspected parkinsonism and scans without evidence of dopaminergic deficit (SWEDDs)","volume":"80","author":"Silveira-Moriyama L","year":"2009","journal-title":"J Neurol Neurosurg Psychiatry","ISSN":"https:\/\/id.crossref.org\/issn\/0022-3050","issn-type":"print"},{"key":"ref17","doi-asserted-by":"crossref","first-page":"S225","DOI":"10.1016\/S1353-8020(08)70006-3","article-title":"Olfaction in Parkinson's disease","volume":"13","author":"Doty RL","year":"2007","journal-title":"Parkinsonism Relat Disord"},{"key":"ref18","first-page":"S123","article-title":"The nonmotor symptoms of Parkinson's disease - an overview","volume":"25","author":"Lim S","year":"2010","journal-title":"Mov Disord","ISSN":"https:\/\/id.crossref.org\/issn\/0855-3185","issn-type":"print"},{"key":"ref19","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1590\/S0004-282X2010000200019","article-title":"Olfactory function and Parkinson's disease in Southern Brazil","volume":"68","author":"Santin R","year":"2010","journal-title":"Arq Neuropsiquiatr","ISSN":"https:\/\/id.crossref.org\/issn\/0004-282X","issn-type":"print"},{"key":"ref20","first-page":"1266","article-title":"Gait in SWEDDs patients: comparison with Parkinson's disease patients and healthy controls","volume":"26","author":"Mian OS","year":"2011","journal-title":"Mov Disord","ISSN":"https:\/\/id.crossref.org\/issn\/0855-3185","issn-type":"print"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"2147","DOI":"10.1007\/s00415-011-6076-z","article-title":"The role of 123I-FP-CIT-SPECT in the differential diagnosis of Parkinson and tremor syndromes: a critical assessment of 125 cases","volume":"258","author":"Sixel-D\u00f6ring F","year":"2011","journal-title":"J Neurol","ISSN":"https:\/\/id.crossref.org\/issn\/0340-5354","issn-type":"print"},{"key":"ref22","first-page":"1415","article-title":"Role of dopamine transporter imaging in routine clinical practice","volume":"18","author":"Marshall V","year":"2003","journal-title":"Mov Disord","ISSN":"https:\/\/id.crossref.org\/issn\/0855-3185","issn-type":"print"},{"key":"ref23","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1007\/s00259-009-1267-x","article-title":"EANM procedure guidelines for brain neurotransmission SPECT using 123I-labelled dopamine transporter ligands, version 2","volume":"37","author":"Darcourt J","year":"2010","journal-title":"Eur J Nucl Med Mol Imaging"},{"key":"ref24","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1016\/j.jns.2009.12.024","article-title":"Evaluation of patients with Clinically Unclear Parkinsonian Syndromes submitted to brain SPECT imaging using the technetium-99m labeled tracer TRODAT-1","volume":"291","author":"Felicio A","year":"2010","journal-title":"J Neurol Sci","ISSN":"https:\/\/id.crossref.org\/issn\/0022-510X","issn-type":"print"},{"key":"ref25","first-page":"1229","article-title":"Role of DAT-SPECT in the diagnostic work up of parkinsonism","volume":"22","author":"Scherfler C","year":"2007","journal-title":"Mov Disord","ISSN":"https:\/\/id.crossref.org\/issn\/0855-3185","issn-type":"print"},{"key":"ref26","doi-asserted-by":"crossref","first-page":"1213","DOI":"10.1007\/s007020050124","article-title":"I]beta-CIT and SPECT in essential tremor and Parkinson's disease","volume":"105","author":"Asenbaum S","year":"1998","journal-title":"J Neural Transm","ISSN":"https:\/\/id.crossref.org\/issn\/0300-9564","issn-type":"print"},{"key":"ref27","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1097\/NRL.0b013e318183fdd8","article-title":"Molecular imaging studies in Parkinson disease: reducing diagnostic uncertainty","volume":"15","author":"Felicio AC","year":"2009","journal-title":"Neurologist","ISSN":"https:\/\/id.crossref.org\/issn\/1074-7931","issn-type":"print"},{"key":"ref28","doi-asserted-by":"crossref","first-page":"1367","DOI":"10.1007\/s00259-008-0777-2","article-title":"The cost effectiveness of 123I-FP-CIT SPECT imaging in patients with an uncertain clinical diagnosis of parkinsonism","volume":"35","author":"Van Laere K","year":"2008","journal-title":"Eur J Nucl Med Mol Imaging"},{"key":"ref29","first-page":"2202","article-title":"Cost-effectiveness of 123I-FP-CIT SPECT in the differential diagnosis of essential tremor and Parkinson's disease in Italy","volume":"23","author":"Antonini A","year":"2008","journal-title":"Mov Disord","ISSN":"https:\/\/id.crossref.org\/issn\/0855-3185","issn-type":"print"}],"container-title":["Arquivos de Neuro-Psiquiatria"],"original-title":[],"link":[{"URL":"http:\/\/www.scielo.br\/pdf\/anp\/v70n9\/v70n9a04.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,7,3]],"date-time":"2019-07-03T23:57:44Z","timestamp":1562198264000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&pid=S0004-282X2012000900004&lng=en&tlng=en"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,9]]},"references-count":29,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2012,9]]}},"alternative-id":["S0004-282X2012000900004"],"URL":"https:\/\/doi.org\/10.1590\/s0004-282x2012000900004","relation":{},"ISSN":["0004-282X"],"issn-type":[{"value":"0004-282X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,9]]}}}