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The role of neuroimaging in the diagnosis of the atypical parkinsonian syndromes in clinical practice
- Neurology Department, St. Adalbert Hospital, Copernicus Podmiot Leczniczy Sp. z o.o., Gdansk, Poland
- Department of Neurological and Psychiatric Nursing, Medical University of Gdansk, Gdańsk, Poland
- Radiology Department, St. Adalbert Hospital, Copernicus Podmiot Leczniczy Sp. z o.o., Gdańsk, Poland
- Nuclear Medicine Department, Medical University of Gdańsk, Gdańsk, Poland
- Neurology Department, Medical University of Warsaw, Warsaw, Poland
open access
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.
Keywords
Magnetic resonance imaging, Progressive supranuclear palsy, Multiple system atrophy, Imaging
Title
The role of neuroimaging in the diagnosis of the atypical parkinsonian syndromes in clinical practice
Journal
Neurologia i Neurochirurgia Polska
Issue
Pages
421-431
Page views
390
Article views/downloads
967
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