open access

Vol 49, No 6 (2015)
Review articles
Submitted: 2015-04-14
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The role of neuroimaging in the diagnosis of the atypical parkinsonian syndromes in clinical practice

Magda Dąbrowska, Michał Schinwelski, Emilia J. Sitek, Anna Muraszko-Klaudel, Bogna Brockhuis, Zygmunt Jamrozik, Jarosław Sławek
DOI: 10.1016/j.pjnns.2015.10.002
·
Neurol Neurochir Pol 2015;49(6):421-431.

open access

Vol 49, No 6 (2015)
Review articles
Submitted: 2015-04-14

Abstract

Atypical parkinsonian disorders (APD) are a heterogenous group of neurodegenerative diseases such as: progressive supranuclear palsy (PSP), multiple system atrophy (MSA), cortico-basal degeneration (CBD) and dementia with Lewy bodies (DLB). In all of them core symptoms of parkinsonian syndrome are accompanied by many additional clinical features not typical for idiopathic Parkinson's disease (PD) like rapid progression, gaze palsy, apraxia, ataxia, early cognitive decline, dysautonomia and usually poor response to levodopa therapy. In the absence of reliably validated biomarkers the diagnosis is still challenging and mainly based on clinical criteria. However, robust data emerging from routine magnetic resonance imaging (MRI) as well as from many advanced MRI techniques such as: diffusion weighted imaging (DWI) and diffusion tensor imaging (DTI), magnetic resonance spectroscopy (MRS), voxel-based morphometry (VBM), susceptibility-weighted imaging (SWI) may help in differential diagnosis. The main aim of this review is to summarize briefly the most important and acknowledged radiological findings of conventional MRI due to its availability in standard clinical settings. Nevertheless, we present shortly other methods of structural (like TCS – transcranial sonography) and functional imaging (like SPECT – single photon emission computed tomography or PET – positron emission tomography) as well as some selected advanced MRI techniques and their potential future applications in supportive role in distinguishing APD.

Abstract

Atypical parkinsonian disorders (APD) are a heterogenous group of neurodegenerative diseases such as: progressive supranuclear palsy (PSP), multiple system atrophy (MSA), cortico-basal degeneration (CBD) and dementia with Lewy bodies (DLB). In all of them core symptoms of parkinsonian syndrome are accompanied by many additional clinical features not typical for idiopathic Parkinson's disease (PD) like rapid progression, gaze palsy, apraxia, ataxia, early cognitive decline, dysautonomia and usually poor response to levodopa therapy. In the absence of reliably validated biomarkers the diagnosis is still challenging and mainly based on clinical criteria. However, robust data emerging from routine magnetic resonance imaging (MRI) as well as from many advanced MRI techniques such as: diffusion weighted imaging (DWI) and diffusion tensor imaging (DTI), magnetic resonance spectroscopy (MRS), voxel-based morphometry (VBM), susceptibility-weighted imaging (SWI) may help in differential diagnosis. The main aim of this review is to summarize briefly the most important and acknowledged radiological findings of conventional MRI due to its availability in standard clinical settings. Nevertheless, we present shortly other methods of structural (like TCS – transcranial sonography) and functional imaging (like SPECT – single photon emission computed tomography or PET – positron emission tomography) as well as some selected advanced MRI techniques and their potential future applications in supportive role in distinguishing APD.

Get Citation

Keywords

Magnetic resonance imaging, Progressive supranuclear palsy, Multiple system atrophy, Imaging

About this article
Title

The role of neuroimaging in the diagnosis of the atypical parkinsonian syndromes in clinical practice

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 49, No 6 (2015)

Pages

421-431

DOI

10.1016/j.pjnns.2015.10.002

Bibliographic record

Neurol Neurochir Pol 2015;49(6):421-431.

Keywords

Magnetic resonance imaging
Progressive supranuclear palsy
Multiple system atrophy
Imaging

Authors

Magda Dąbrowska
Michał Schinwelski
Emilia J. Sitek
Anna Muraszko-Klaudel
Bogna Brockhuis
Zygmunt Jamrozik
Jarosław Sławek

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