COMPARATIVE ANALYSES IN BRAIN’S MRI (NIGROSOME AND NEUROMELANIN) VERSUS 99mmTc-TRODAT-1 SPECT IN MOVEMENT DISORDERS (P4.020)

Objective: Study the diagnosis performance of the brain MRI N-M and SPECT scans [99mTc]-TRODAT-1 in the evaluation of extrapyramidal disorders. Background: Parkinson’s disease is caused by loss of dopamine neurons in the substantia nigra. The diagnosis may be a challenging task due to the large clinical spectrum of the disease and variable treatment response. There are a number of other conditions that mimic the clinical presentation of PD, each of which should be considered during differential diagnosis. The SPECT scans [99mTc]-TRODAT-1 and MRI-3T to study the nigrosome and neuromelanin (N-M) can be useful tools for the clinical management. Design/Methods: Patients with any signs or symptoms of extra-piramidal involvement were prospectively evaluated. The individuals underwent magnetic resonance imaging with N-M analysis and SPECT scans [99mTc]-TRODAT-1. Neuroradiologists performing the N-M analysis were blinded for the clinical features. Results: Sixty-three patients were evaluated (33 women). The average age was 70.7 years (±15.36). They were classified into groups. Group 1 PD: 29 patients; 2 - Parkinson-plus: 4 patients; 3 - secondary parkinsonism: 25 patients; 4 – essential tremor: 4 patients; 5 - restless legs syndrome: 1 patient. The N-M signs in brain MRI were abnormal in all patients from groups 1 and 2 and in only one individual from group 3. Thirty-two patients underwent SPECT scans [99mTc]-TRODAT-1; 16 from group 1; two from group 2; nine from group 3; four from group 4 and one from group 5. Only one individual from group 4 had normal SPECT scans [99mTc]-TRODAT-1 and in the remaining subjects it was abnormal. Conclusions: SPECT scans [99mTc]-TRODAT-1 had high sensitivity for detecting PD and Parkinson plus syndromes, but low specificity. The brain MRI N-M analysis on the other hand had high sensitivity and specificity on this group of patients. The associated analysis of the nigrossomo and neuromelanin signs added to the diagnostic yield of the methods. Disclosure: Dr. Baeta has nothing to disclose. Dr. Schmid has nothing to disclose. Dr. Sandes has nothing to disclose. Dr. Teixeira has nothing to disclose. Dr. Rigo has nothing to disclose. Dr. Escorcio-Bezerra has nothing to disclose. Dr. Marussi has nothing to disclose. Dr. Belezia has nothing to disclose.