Key result
A normal DaTscan result was significantly more likely to lead to a change in clinical management compared to an abnormal scan (60% vs 15%, p=0.009).
Why the study?
Diagnosing clinically uncertain parkinsonian syndromes is challenging, and the real-world impact of DaTscan on management in Canada, where it is not publicly funded, remains unclear.
Does DaTscan result impact clinical management in patients with clinically uncertain parkinsonian syndromes?
Cohort (n=42)
No
Does DaTscan result impact clinical management in patients with clinically uncertain parkinsonian syndromes?
DaTscan results informed management in 31% of CUPS patients, with normal scans significantly more likely to lead to management changes, primarily discontinuing dopaminergic therapy.
Normal DaTscan may influence management decisions more often; leaves open effects on outcomes and need for prospective validation.
Background: Diagnosing clinically uncertain parkinsonian syndromes (CUPS) is challenging. Dopamine transporter (DaT) SPECT imaging (DaTscan) aids in differentiation, but its real-world impact on management in Canada, where it is not publicly funded, is unclear. The objective was to determine the impact of DaTscan results on clinical management for patients with CUPS in a Canadian tertiary care movement disorder service. Methods: We conducted a retrospective chart review of 42 patients with CUPS referred for a DaTscan from a tertiary clinic in London, Ontario. DaTscan result was categorized as “Abnormal” (positive scan) or “Normal” (negative scan). The primary outcome was a change in management (Present/Absent). The association was assessed using Fisher’s Exact test. Results: Forty-two patients were included (median age 63 years; 50% female). Twenty-seven scans (64%) were abnormal, and 15 (36%) were normal. Overall, clinical management was changed in 13 patients (31%; 95% CI: 18% to 47%). A change in management was significantly more likely after a normal scan (60%, 9/15 patients) compared to an abnormal scan (15%, 4/27 patients) ( p = 0.009). Changes after a normal scan primarily involved discontinuing dopaminergic therapy (7/9, 78%). Conclusions: In this specialized clinic, DaTscan results informed management in 31% of CUPS patients. A normal scan provides the objective evidence needed to withdraw unnecessary dopaminergic medications confidently.
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Mani et al. (2026) conducted a cohort in clinically uncertain parkinsonian syndromes (CUPS) (n=42). Normal DaTscan result vs. Abnormal DaTscan result was evaluated on change in management (p=0.009). A normal DaTscan result was significantly more likely to lead to a change in clinical management compared to an abnormal scan (60% vs 15%, p=0.009).
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