{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T15:04:53Z","timestamp":1789657493784,"version":"4.0.1"},"reference-count":13,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2021,4,13]],"date-time":"2021-04-13T00:00:00Z","timestamp":1618272000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPD"],"published-print":{"date-parts":[[2021,4,13]]},"abstract":"<jats:p>Background: The diagnosis of Parkinson\u2019s disease (PD) is primarily clinical, but in cases of diagnostic uncertainty, evaluation of nigrostriatal dopaminergic degeneration (NSDD) by imaging of the dopamine transporter using DaTscan with single-photon emission computed tomography (SPECT) brain imaging may be helpful. Objective\/Methods: In the current paper, we describe clinical scenarios for which DaTscan imaging was used in a prospective case series of 201 consecutive patients in whom a movement disorder specialist ordered DaTscan imaging to clarify NSDD. We describe the impact of DaTscan results on changing or confirming pre-DaTscan clinical diagnosis and on post-DaTscan treatment changes. Results\/Conclusion: DaTscan imaging can be useful in several clinical scenarios to determine if NSDD is present. These include in patients with early subtle symptoms, suboptimal response to levodopa, prominent action tremor, drug-induced parkinsonism, and in patients with lower extremity or other less common parkinsonism clinical presentations. We also found DaTscan imaging to be useful to determine underlying NSDD in patients with PD diagnosis for 3-5 years but without apparent clinical progression or development of motor fluctuations. Overall, in 201 consecutive patients with clinically questionable NSDD, DaTscan was abnormal in 58.7% of patients, normal in 37.8%, and inconclusive in 3.5%. DaTscan imaging changed clinical diagnosis in 39.8% of patients and led to medication therapy changes in 70.1% of patients.<\/jats:p>","DOI":"10.3233\/jpd-202506","type":"journal-article","created":{"date-parts":[[2021,2,2]],"date-time":"2021-02-02T20:13:14Z","timestamp":1612296794000},"page":"885-889","source":"Crossref","is-referenced-by-count":14,"title":["Impact of DaTscan Imaging on Clinical Decision Making in Clinically Uncertain Parkinson\u2019s Disease"],"prefix":"10.1177","volume":"11","author":[{"given":"Jonathan R.","family":"Isaacson","sequence":"first","affiliation":[{"name":"Parkinson\u2019s Disease and Movement Disorders Center of Boca Raton, Boca Raton, FL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salima","family":"Brillman","sequence":"additional","affiliation":[{"name":"Parkinson\u2019s Disease and Movement Disorders Center of Boca Raton, Boca Raton, FL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nisha","family":"Chhabria","sequence":"additional","affiliation":[{"name":"Parkinson\u2019s Disease and Movement Disorders Center of Boca Raton, Boca Raton, FL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stuart H.","family":"Isaacson","sequence":"additional","affiliation":[{"name":"Parkinson\u2019s Disease and Movement Disorders Center of Boca Raton, Boca Raton, FL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","reference":[{"key":"10.3233\/JPD-202506_ref1","doi-asserted-by":"crossref","first-page":"1591","DOI":"10.1002\/mds.26424","article-title":"MDS clinical diagnostic criteria for Parkinson\u2019s disease","volume":"30","author":"Postuma","year":"2015","journal-title":"Mov Disord"},{"key":"10.3233\/JPD-202506_ref2","doi-asserted-by":"crossref","first-page":"566","DOI":"10.1212\/WNL.0000000000002350","article-title":"Accuracy of clinical diagnosis of Parkinson 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Disord"},{"key":"10.3233\/JPD-202506_ref9","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1159\/000370116","article-title":"Is there a role for DAT-SPECT imaging in a specialty movement disorders practice?","volume":"15","author":"Bega","year":"2015","journal-title":"Neurodegener Dis"},{"key":"10.3233\/JPD-202506_ref10","first-page":"1","article-title":"Dopamine transporter (DaT) scan utilization in a movement disorder center","volume":"3","author":"Oravivattanakul","year":"2015","journal-title":"Mov Disord Clin Pract"},{"key":"10.3233\/JPD-202506_ref11","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1097\/RLU.0000000000000766","article-title":"The impact of DaTscan in the diagnosis of Parkinson disease","volume":"40","author":"Gayed","year":"2015","journal-title":"Clin Nucl Med"},{"key":"10.3233\/JPD-202506_ref12","doi-asserted-by":"crossref","first-page":"116454","DOI":"10.1016\/j.jns.2019.116454","article-title":"Invalidation of Parkinson\u2019s disease diagnosis after years of follow-up based on clinical, radiological and neurophysiological examination","volume":"406","author":"Coarelli","year":"2019","journal-title":"J Neurol Sci"},{"key":"10.3233\/JPD-202506_ref13","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1159\/000447561","article-title":"Clinical impact of 123I-Ioflupane SPECT (DaTscan) in a movement disorder center","volume":"17","author":"Graebner","year":"2017","journal-title":"Neurodegener Dis"}],"container-title":["Journal of Parkinson's 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