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CC BY 4.0 · World J Nucl Med
DOI: 10.1055/s-0045-1812051
Case Report

Huntington's Disease with Parkinson-Like Symptoms and Abnormal [123I] Ioflupane SPECT-CT (DaTs): A Case Report and Literature Review

Authors

  • Sarah Amro 

    1   Department of Nuclear Medicine, Royal Sussex County Hospital, Brighton, United Kingdom
    2   Department of Nuclear Medicine, University Hospitals Sussex NHS Foundation Trust, Brighton, United Kingdom

  • Chamani Punchihewa 

    2   Department of Nuclear Medicine, University Hospitals Sussex NHS Foundation Trust, Brighton, United Kingdom

  • Edina Bravo

    3   Department of Neurology, University Hospitals Sussex NHS Foundation Trust, Brighton, United Kingdom

  • Sabina Dizdarevic

    1   Department of Nuclear Medicine, Royal Sussex County Hospital, Brighton, United Kingdom
    4   Department of Nuclear Medicine, Brighton and Sussex Medical School, Brighton, United Kingdom
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Abstract

Huntington's disease (HD) is an autosomal dominant neurodegenerative disorder caused by an unstable expansion of CAG trinucleotide repeats that lead to progressive degeneration of postsynaptic striatal medium-spiny GABAergic neurons. We report a case of abnormal [123I] Ioflupane single-photon emission computed tomography/computed tomography (DaTSCAN) and a subsequent genetic test confirming HD. A 68-year-old man presented with progressive memory difficulties, auditory hallucinations, nightmares, suicidal thoughts, low mood, and involuntary limb movements. DaTSCAN showed borderline reduced putaminal binding ratios bilaterally, more prominent on the left side, and a low putamen-to-caudate ratio suggesting degenerative parkinsonism. Genetic testing revealed one pathogenic expansion (40/17 CAG repeats), confirming HD. Postsynaptic dopaminergic involvement has previously been documented in postmortem studies. However, an emerging in vivo research also suggests presynaptic dopaminergic involvement. While genetic testing remains the gold standard for diagnosis of HD, DaTSCAN may play a role in assessing dopamine transporter activity and tracking the progression of neurodegeneration in HD.

Keywords

Huntington's disease - DaTSCAN - dopamine transporter imaging - neurodegeneration - [123I] Ioflupane

Previous Presentation

This case was accepted and will be presented as a poster at the BNMS (British Nuclear Medicine Society) Spring Annual meeting 2025 in Scotland by the same authors.


Ethical Approval

The patient had been referred for standard routine imaging and had not been exposed to excess radioactive material beyond the standard of care. As per the National Health Service clinical practice, all patients were verbally informed by medical professionals that their anonymized scans may be used for teaching, including case studies, audit, and or research purposes.


Authors' Contributions

C.P.: data collection, revision, and edition; E.B.: revision and edition; S.D.: contributing to abstract and manuscript, including editing, supervision, and literature review.

The article has been read and approved by all the authors that the requirements for authorship as stated have been met, and each author believes that the article represents honest work.




Publication History

Article published online:
04 October 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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