Possible Parkinson's diagnosis - which tests should I get?

Hello @palladium and welcome to the Parkinson's support group on Mayo Connect. Generally, when you are being diagnosed for PD, the neurologist will run a number of tests to rule out other neurological disorders and also look for markers that indicate PD.

As you seem to be concerned about which test to undergo, this seems like a good question to ask your neurologist. Is there a reason for your hesitancy?

Before my diagnosis, I was having gait difficulties, and balance problem. What type of symptoms have you had that led you to see a neurologist?

My wife recently had Spect test along with blood work for vit.b12 which was extremely low & may explain her fatigue. After starting b12 sublingual drops daily her fatigue disappeared. Also blood work on several vitamins & heavy metals. No evidence of heavy metals. Low vit.D. All other vitamins & blood work was normal.

Glad you connected with @hopeful33250 and @angels81, @palladium. Tagging a few members who may have input on what tests you should be sure to get to determine if you have Parkinson's @azsingularity @seniormed @cmdw2600 @cctee @dlc1953 @jflamini. They may have input specifically on getting skin punch biopsy looking for phosphorylated alpha-synuclein and/or the single photon emission computed tomography (SPECT).

Also, palladium, here is some Mayo Clinic information on the SPECT scan and skin biopsies, including the skin punch biopsy:

- SPECT scan https://www.mayoclinic.org/tests-procedures/spect-scan/about/pac-20384925

- Skin biopsy https://www.mayoclinic.org/tests-procedures/skin-biopsy/about/pac-20384634

Here is some information specifically about Parkinson's, including a tab on diagnosis and treatment:

- Parkinson's disease https://www.mayoclinic.org/diseases-conditions/parkinsons-disease/symptoms-causes/syc-20376055

I don't have much useful input, since I'm not officially diagnosed--just "at risk" (due to the RBD). So, my neurologist didn't feel any advanced testing, scans, etc. are warranted at this time. I'm only doing the yearly screening to monitor for PD symptoms.

If you're neurologist is confident enough to suggest "possible Parkinson's" then I imagine they will tell you which tests to get next. That said, my question would be the same as @hopeful33250's: are you hesitant about some of the tests for any reason?

@palladium Just got the Syn-One test 2 weeks ago, waiting for results. The Doctor I saw seemed quite confident in the reliability of it. Also, I’m testing for orthostatic hypotension, had a tilt table test also. I am more concerned about Parkinson cousin, MSA. Do you have any autonomic symptoms, if so you might have to branch out to cardiology for those tests. I’m hoping you do not.

Hello @angels81,

I appreciate the update. Does your wife have the results of the Spect test yet?

Yes & report states it is suggested that she has PD. Also observation of her walk/gait & tremors in left hand & left leg. MRI indicated right side of brain where dopamine is produced is worse than left side.

My husband had various bloodwork and a DATSCAN which measures the dopamine levels in your brain. My husband was primarily effected on his right side with his right arm that just hangs, stumbling, his gait always drifts to the right and on occasion he shuffles with short steps. He also experiences a bit of pain, but I have managed to control most of it with Tramadol, Ropinirole, Ibuprofen and Tylenol. The meds must be taken at approximately the same time each day. He was diagnosed in Oct 2024 at UF Shands.

The skin test is highly accurate to detect alpha synuclein
in our skin tissue. It is not definitive for any of the three
neuro diagnoses but adds more sensitivity to the dopamine and PET scans. Our symptoms and history
presented to the neurologist are what helps them firm up our diagnosis. I’m thinking my family history of PD
with my sister and grandfather are very contributory.
I do have input from cardiology with autonomic symptoms. I’m having my dermatologist do the biopsies
for the SynOne kit since he does punch biopsies routinely. I have autoimmune arthritis which can amplify the dysautonomia so hope both chronic problems don’t worsen at once. I am fortunate with a great team and make sure they are all in the loop.