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Imaging Parkinson's disease below the neck.

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Parkinson's disease involves widespread alpha-synuclein pathology in the nervous system, affecting the gastrointestinal tract early. Imaging techniques reveal autonomic dysfunction years before diagnosis, aiding research into disease mechanisms.

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Area of Science:

  • Neurology
  • Gastroenterology
  • Radiology

Background:

  • Parkinson's disease (PD) is a systemic disorder characterized by alpha-synuclein pathology.
  • This pathology affects the autonomic and enteric nervous systems, appearing in the gastrointestinal tract before clinical diagnosis.
  • Autonomic symptoms, including gastrointestinal and genitourinary issues, often precede PD diagnosis by years.

Purpose of the Study:

  • To review the methodology and findings of radio-isotope and radiological imaging for peripheral pathology in Parkinson's disease.
  • To highlight the role of in vivo imaging in studying the hypothesis of alpha-synuclein aggregation and spread in PD.

Main Methods:

  • Utilizing radiotracers like 123I-meta-iodobenzylguanidin, 18F-dopamine, and 11C-donepezil to assess sympathetic and parasympathetic nerve terminal function.
  • Employing other radiotracer and radiological imaging methods to evaluate gastrointestinal and anorectal functions.

Main Results:

  • Demonstrated loss of sympathetic and parasympathetic nerve terminal function in Parkinson's disease patients.
  • Revealed prevalent dysfunction in pharyngeal/esophageal motility, gastric emptying, colonic transit, and anorectal function using imaging modalities.

Conclusions:

  • Peripheral autonomic dysfunction is a significant feature of Parkinson's disease, detectable via advanced imaging.
  • Radio-isotope and radiological imaging are essential tools for investigating the early stages and progression of Parkinson's disease pathology.