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Movement disorders: role of imaging in diagnosis
Author(s) -
Mascalchi Mario,
Vella Alessandra,
Ceravolo Roberto
Publication year - 2012
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.23547
Subject(s) - parkinsonism , putamen , progressive supranuclear palsy , corticobasal degeneration , basal ganglia , movement disorders , medicine , magnetic resonance imaging , dopamine transporter , atrophy , white matter , dementia with lewy bodies , spect imaging , diffusion mri , pathology , neuroscience , nuclear medicine , psychology , radiology , dopamine , disease , dementia , central nervous system , dopaminergic
Magnetic resonance imaging (MRI and single‐photon emission computed tomography (SPECT) have a considerable role in the diagnosis of the single patient with movement disorders. Conventional MRI demonstrates symptomatic causes of parkinsonism but does not show any specific finding in Parkinson's disease (PD). However, SPECT using tracers of the dopamine transporter (DAT) demonstrates an asymmetric decrease of the uptake in the putamen and caudate from the earliest clinical stages. In other degenerative forms of parkinsonism, including progressive supranuclear palsy (PSP), multisystem atrophy (MSA), and corticobasal degeneration (CBD), MRI reveals characteristic patterns of regional atrophy combined with signal changes or microstructural changes in the basal ganglia, pons, middle and superior cerebellar peduncles, and cerebral subcortical white matter. SPECT demonstrates a decreased uptake of tracers of the dopamine D2 receptors in the striata of patients with PSP and MSA, which is not observed in early PD. MRI also significantly contributes to the diagnosis of some inherited hyperkinetic conditions including neurodegeneration with brain iron accumulation and fragile‐X tremor/ataxia syndrome by revealing characteristic symmetric signal changes in the basal ganglia and middle cerebellar peduncles, respectively. A combination of the clinical features with MRI and SPECT is recommended for optimization of the diagnostic algorithm in movement disorders. J. Magn. Reson. Imaging 2012 © 2012 Wiley Periodicals, Inc.