Neuroimaging in Parkinsonian Disorders

Area of Science:

• Neurology
• Radiology
• Medical Imaging

Background:

• Parkinson's disease (PD) diagnosis relies on clinical symptoms, but neuroimaging offers objective insights.
• Neuroimaging techniques probe brain changes related to neurotransmitter deficits and network alterations underlying PD motor symptoms.

Purpose of the Study:

• To review the role of various neuroimaging modalities in the diagnosis and classification of Parkinson's disease and related parkinsonian syndromes.
• To highlight how neuroimaging supports the Movement Disorders Society Clinical Diagnostic Criteria for PD.

Main Methods:

• Functional neuroimaging (PET, SPECT) to assess neurotransmitter systems.
• Morphological imaging (MRI, transcranial sonography) for structural analysis.
• Advanced MR techniques and metabolic imaging (FDG-PET) for classification and differential diagnosis.

Main Results:

• Dopaminergic imaging differentiates neurodegenerative from non-degenerative parkinsonism and aids in diagnosing dementia with Lewy bodies (DLB) versus Alzheimer's disease (AD).
• Metabolic and network patterns identified via PET enable automated classification of parkinsonian syndromes.
• Structural MRI and advanced MR techniques assist in classifying PD and atypical parkinsonian syndromes.

Conclusions:

• Multimodal neuroimaging provides an objective and accurate diagnostic classification of PD spectrum disorders by revealing underlying neurochemical and neuroanatomical changes.
• Developing in-vivo alpha-synuclein imaging remains a key challenge for advancing PD diagnostics.