Structural and Molecular Imaging for Clinically Uncertain Parkinsonism.

Area of Science:

• Neurology
• Radiology
• Neuroscience

Background:

• Parkinson disease (PD) diagnosis is challenging, especially in early stages or when symptoms mimic other movement disorders.
• Clinical presentation of parkinsonism can differ from pathological findings.
• Sophisticated neuroimaging is crucial for understanding PD's molecular basis and progression.

Purpose of the Study:

• To explore the role of advanced neuroimaging in diagnosing Parkinson disease.
• To differentiate PD from other parkinsonian syndromes.
• To highlight clinically accessible imaging modalities for uncertain cases.

Main Methods:

• Review of ultra-high-field imaging techniques and their diagnostic capabilities.
• Analysis of neuroimaging's ability to detect microstructural, neural pathway, metabolic, and blood flow alterations.
• Discussion of diagnostic approaches for clinically uncertain parkinsonism.

Main Results:

• Advanced neuroimaging offers improved spatial resolution and contrast for detecting subtle brain changes.
• Imaging can identify molecular mechanisms, phenotypic variations, and compensatory strategies in PD.
• Ultra-high-field techniques reveal microstructural changes and neural pathway disruptions.

Conclusions:

• Neuroimaging is vital for accurate Parkinson disease diagnosis and understanding disease mechanisms.
• Advanced imaging techniques enhance the differentiation of PD from other movement disorders.
• A structured approach using accessible imaging modalities can aid in diagnosing uncertain parkinsonism.