Objective: To correlate different clinical features of parkinsonism with regional variations of presynaptic dopaminergic dysfunction of the basal ganglia using quantitative DaTscans.

Background: DaT-SPECT imaging is currently approved in the US for differentiating essential tremor from parkinsonism. Previous studies done to correlate clinical features of parkinsonism with regional variation in denervation have primarily used visual methods of assessments. Although visual methods are widely employed in assessing DaTscans, a quantitative approach provides us with more objective and region-specific data on dopaminergic denervation of the basal ganglia.

Methods: A retrospective chart review of 53 consecutive patients who had quantitative DaTscans performed from April 2017 to September 2017 was conducted. Symptoms of prodromal parkinsonism as well as motor and non-motor features present, were obtained from patients’ records. These were correlated with dopaminergic dysfunction of the basal ganglia provided by quantitative DaTscans. The significance was assessed by t-test analyses.

Results: Of the 53 patients who had quantitative DaTscans performed, we found statistical significant correlations in 11 patients with REM behavior disorder, 5 patients with loss of smell, and 6 patients with dementia (p-values < 0.05). The data obtained suggested that the loss of smell was associated with the denervation of the caudate. Dementia was noted to be associated with asymmetric denervation of the caudate and striatum but not the putamen. REM behavior disorder appeared to have a more generalized denervation pattern involving multiple regions of the basal ganglia. No significant correlations could be found with other clinical features that were analyzed.

Conclusions: Patients with loss of smell or dementia had more localized dopaminergic dysfunction of the basal ganglia, while patients with REM behavior disorder demonstrated a diffuse denervation pattern. Further studies looking at early denervation patterns of the basal ganglia may be useful in determining whether quantitative DaTscans can be used as a diagnostic tool in predicting dementia in patients with parkinsonism.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/does-dopaminergic-denervation-of-specific-anatomical-regions-of-the-basal-ganglia-correlate-with-clinical-features-of-parkinsonism-a-quantitative-datscan-study/