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PPA – SLT Strategies — SCE Neurology MCQ

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HardNeurorehabilitationPPA – SLT StrategiesSCE Neurology

A patient with progressive asymmetric rigidity, apraxia and cortical sensory loss has reduced posterior putaminal uptake on DAT-SPECT. Which conclusion can the scan support?

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Correct answer: B — A presynaptic dopaminergic deficit is present, without syndrome-specific discrimination

Explanation lettering: C = shown as B · D = shown as C · E = shown as D · B = shown as E

C is correct. Abnormal DAT imaging demonstrates a presynaptic nigrostriatal deficit but overlaps across Parkinson disease, DLB, MSA, PSP and CBD; clinical phenotype still determines the syndrome. A overstates specificity. B confuses presynaptic transporter with postsynaptic receptor imaging. D reverses the usual finding in pure drug-induced parkinsonism, where DAT binding is generally preserved. E is false because DLB commonly has reduced uptake.

Reference: EANM/SNMMI dopaminergic-imaging guideline: https://pmc.ncbi.nlm.nih.gov/articles/PMC7300075/