In recent years an increasing number of studies have demonstrated the usefulness of different magnetic resonance (MR) techniques in diagnosing and understanding Parkinson's disease (PD). First, several MRbased studies have identified promising markers of substantia nigra degeneration in PD for early diagnosis and the evaluation of disease progression. Second, quantitative MR techniques have been used to improve the differential diagnosis among parkinsonian syndromes. Among these, the most reproducible and consistent are morphometry and diffusion imaging, both of which are able to detect degenerative changes of cerebral structures specifically affected in the different forms of parkinsonism. Finally, advanced MR techniques such as functional MRI, voxel-based morphometry, and diffusion tensor imaging have provided insights into many pathophysiological aspects of PD. Currently, the main limitation to the use of advanced MR techniques is the heterogeneity of results among previous studies. This is due not only to a combination of technical variability in terms of magnetic fields, sequences, and methodological approaches of analysis, but also most likely to the differences in the patient samples examined, given that in most studies the subjects lack a pathological diagnosis. Furthermore, most of the diagnostic studies were performed in patients with long disease duration and it is not clear whether reported MRI findings allow an accurate differential diagnosis to be performed in the early stage of disease. Among pathophysiological studies in particular, there is currently a gap in our understanding of the link between some of the alterations described in the literature and their possible pathogenic role. This especially true of the studies focused on symptoms occurring in later stage of disease, such as L-dopa induced dyskinesia and gait impairment, at a stage when additional clinical features may bias the results. A methodological consensus and a reduction of operator dependence would allow a reduction in inhomogeneity of results related to the technical variability. Regarding the characteristics of the patients examined, future studies should include larger and more homogeneous samples. In the diagnostic setting, the patients should be examined in the early stage of the disease, longitudinal studies should be preferred and a definite pathological diagnosis should be obtained

Looking into the brain: How can conventional, morphometric and functional MRI help in diagnosing and understanding PD? / Giovanni Rizzo;Caterina Tonon;Raffaele Lodi. - In: BASAL GANGLIA. - ISSN 2210-5336. - ELETTRONICO. - 2:4(2012), pp. 175-182. [10.1016/j.baga.2012.06.001]

Looking into the brain: How can conventional, morphometric and functional MRI help in diagnosing and understanding PD?

RIZZO, GIOVANNI;TONON, CATERINA;LODI, RAFFAELE
2012

Abstract

In recent years an increasing number of studies have demonstrated the usefulness of different magnetic resonance (MR) techniques in diagnosing and understanding Parkinson's disease (PD). First, several MRbased studies have identified promising markers of substantia nigra degeneration in PD for early diagnosis and the evaluation of disease progression. Second, quantitative MR techniques have been used to improve the differential diagnosis among parkinsonian syndromes. Among these, the most reproducible and consistent are morphometry and diffusion imaging, both of which are able to detect degenerative changes of cerebral structures specifically affected in the different forms of parkinsonism. Finally, advanced MR techniques such as functional MRI, voxel-based morphometry, and diffusion tensor imaging have provided insights into many pathophysiological aspects of PD. Currently, the main limitation to the use of advanced MR techniques is the heterogeneity of results among previous studies. This is due not only to a combination of technical variability in terms of magnetic fields, sequences, and methodological approaches of analysis, but also most likely to the differences in the patient samples examined, given that in most studies the subjects lack a pathological diagnosis. Furthermore, most of the diagnostic studies were performed in patients with long disease duration and it is not clear whether reported MRI findings allow an accurate differential diagnosis to be performed in the early stage of disease. Among pathophysiological studies in particular, there is currently a gap in our understanding of the link between some of the alterations described in the literature and their possible pathogenic role. This especially true of the studies focused on symptoms occurring in later stage of disease, such as L-dopa induced dyskinesia and gait impairment, at a stage when additional clinical features may bias the results. A methodological consensus and a reduction of operator dependence would allow a reduction in inhomogeneity of results related to the technical variability. Regarding the characteristics of the patients examined, future studies should include larger and more homogeneous samples. In the diagnostic setting, the patients should be examined in the early stage of the disease, longitudinal studies should be preferred and a definite pathological diagnosis should be obtained
2012
Looking into the brain: How can conventional, morphometric and functional MRI help in diagnosing and understanding PD? / Giovanni Rizzo;Caterina Tonon;Raffaele Lodi. - In: BASAL GANGLIA. - ISSN 2210-5336. - ELETTRONICO. - 2:4(2012), pp. 175-182. [10.1016/j.baga.2012.06.001]
Giovanni Rizzo;Caterina Tonon;Raffaele Lodi
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11585/153779
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