Utilidad del [99m] Tc TRODAT-1 en el diagnóstico de la Enfermedad de Parkinson: revisión sistemática de la literatura

Abstract

Purpose: Parkinson disease (PD) is a degenerative disorder. The clinical symptoms of this disease are resting tremor, rigidity and bradykinesia. The purpose of this literature review is to determine the utility of TRODAT -1 in the diagnosis of PD. A search covered PUBMED, COCHRANE, MEDLINE, LILACS and SCIELO databases, between January 1998 and January 2008. Study selection: Twenty six articles were obtained with their respective abstracts. After the first review, ten of them were chosen and only six of them met the inclusion criteria. Four articles were classified as grade evidence (+) and two as grade evidence (-) according to NICE guides. All the articles reviewed report significantly decreased striatal uptake of TRODAT-1 in early PD patients, suggesting that this is a useful, safe, and inexpensive tool in the diagnosis of early PD. It was not possible to perform a meta-analysis with the chosen articles because only three of them reported sensitivity and specificity, and each of these used different criteria for their semi-quantitative analyses. This variability makes comparison of the semi-quantitative uptake criteria impossible. Conclusions: Establishment of a universal technique for quantitation of TRODAT-1 uptake is necessary in order to make meta-analysis viable and allow comparison of the usefulness of this agent among large numbers of patients and multiple populations. Keywords: Parkinson disease, parakysis agitans, Lewy bodies parkinson disease, 99m Tc TRODAT-1, SPECT, Single-Photon Emission-Computed Tomography, Radionuclide Tomography, Single-Photon Emission-Computed.