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Parkinson Disease
Santhosh Gaddikeri, MD; Miral D. Jhaveri, MD, MBA
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Abbreviations

              • Idiopathic Parkinson disease (PD), paralysis agitans
            • Definitions

              • Progressive neurodegenerative disease predominantly caused by primary disorder of pars compacta of substantia nigra (SNpc)
              • Parkinsonism: Syndrome characterized by rigidity, tremor, bradykinesia, & postural imbalance
                • Idiopathic PD (typically responsive to L-dopa therapy)
                • "Parkinson-plus" syndrome/atypical PD: Parkinsonism combined with other clinical signs
                  • e.g., dementia with Lewy bodies, multiple system atrophy, progressive supranuclear palsy, corticobasal degeneration

            IMAGING

            • General Features

              • CT Findings

                • MR Findings

                  • Ultrasonographic Findings

                    • Nuclear Medicine Findings

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Gross Pathologic & Surgical Features

                              • Microscopic Features

                                CLINICAL ISSUES

                                • Presentation

                                  • Demographics

                                    • Natural History & Prognosis

                                      • Treatment

                                        DIAGNOSTIC CHECKLIST

                                        • Consider

                                          • Image Interpretation Pearls

                                            Selected References

                                            1. Arai N et al: Visualization of nigrosome 1 from the viewpoint of anatomic structure. AJNR Am J Neuroradiol. 41(1):86-91, 2020
                                            2. Bharti K et al: Neuroimaging advances in Parkinson's disease with freezing of gait: a systematic review. Neuroimage Clin. 24:102059, 2019
                                            3. Marino BLB et al: Parkinson's disease: a review from the pathophysiology to diagnosis, new perspectives for pharmacological treatment. Mini Rev Med Chem. ePub, 2019
                                            4. Atkinson-Clement C et al: Diffusion tensor imaging in Parkinson's disease: review and meta-analysis. Neuroimage Clin. 16:98-110, 2017
                                            5. Meles SK et al: Metabolic imaging in Parkinson disease. J Nucl Med. 58(1):23-8, 2017
                                            6. Pagano G et al: Imaging in Parkinson's disease. Clin Med (Lond). 16(4):371-5, 2016
                                            7. Booth TC et al: The role of functional dopamine-transporter SPECT imaging in parkinsonian syndromes, part 2. AJNR Am J Neuroradiol. 36(2):236-44, 2015
                                            8. Goveas J et al: Diffusion-MRI in neurodegenerative disorders. Magn Reson Imaging. 33(7):853-76, 2015
                                            9. Kalia LV et al: Parkinson's disease. Lancet. 386(9996):896-912, 2015
                                            10. Broski SM et al: Structural and functional imaging in parkinsonian syndromes. Radiographics. 34(5):1273-92, 2014
                                            11. Cosottini M et al: MR imaging of the substantia nigra at 7 T enables diagnosis of Parkinson disease. Radiology. 271(3):831-8, 2014
                                            12. Brooks DJ et al: Imaging biomarkers in Parkinson's disease. Prog Neurobiol. 95(4):614-28, 2011
                                            13. Wallis LI et al: MRI assessment of basal ganglia iron deposition in Parkinson's disease. J Magn Reson Imaging. 28(5):1061-7, 2008
                                            14. Minati L et al: Imaging degeneration of the substantia nigra in Parkinson disease with inversion-recovery MR imaging. AJNR Am J Neuroradiol. 28(2):309-13, 2007
                                            15. Oikawa H et al: The substantia nigra in Parkinson disease: proton density-weighted spin-echo and fast short inversion time inversion-recovery MR findings. AJNR Am J Neuroradiol. 23(10):1747-56, 2002
                                            Related Anatomy
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                                            Related Differential Diagnoses
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                                            References
                                            Tables

                                            Tables

                                            KEY FACTS

                                            • Terminology

                                              • Imaging

                                                • Top Differential Diagnoses

                                                  • Pathology

                                                    • Clinical Issues

                                                      TERMINOLOGY

                                                      • Abbreviations

                                                        • Idiopathic Parkinson disease (PD), paralysis agitans
                                                      • Definitions

                                                        • Progressive neurodegenerative disease predominantly caused by primary disorder of pars compacta of substantia nigra (SNpc)
                                                        • Parkinsonism: Syndrome characterized by rigidity, tremor, bradykinesia, & postural imbalance
                                                          • Idiopathic PD (typically responsive to L-dopa therapy)
                                                          • "Parkinson-plus" syndrome/atypical PD: Parkinsonism combined with other clinical signs
                                                            • e.g., dementia with Lewy bodies, multiple system atrophy, progressive supranuclear palsy, corticobasal degeneration

                                                      IMAGING

                                                      • General Features

                                                        • CT Findings

                                                          • MR Findings

                                                            • Ultrasonographic Findings

                                                              • Nuclear Medicine Findings

                                                                • Imaging Recommendations

                                                                  DIFFERENTIAL DIAGNOSIS

                                                                    PATHOLOGY

                                                                    • General Features

                                                                      • Gross Pathologic & Surgical Features

                                                                        • Microscopic Features

                                                                          CLINICAL ISSUES

                                                                          • Presentation

                                                                            • Demographics

                                                                              • Natural History & Prognosis

                                                                                • Treatment

                                                                                  DIAGNOSTIC CHECKLIST

                                                                                  • Consider

                                                                                    • Image Interpretation Pearls

                                                                                      Selected References

                                                                                      1. Arai N et al: Visualization of nigrosome 1 from the viewpoint of anatomic structure. AJNR Am J Neuroradiol. 41(1):86-91, 2020
                                                                                      2. Bharti K et al: Neuroimaging advances in Parkinson's disease with freezing of gait: a systematic review. Neuroimage Clin. 24:102059, 2019
                                                                                      3. Marino BLB et al: Parkinson's disease: a review from the pathophysiology to diagnosis, new perspectives for pharmacological treatment. Mini Rev Med Chem. ePub, 2019
                                                                                      4. Atkinson-Clement C et al: Diffusion tensor imaging in Parkinson's disease: review and meta-analysis. Neuroimage Clin. 16:98-110, 2017
                                                                                      5. Meles SK et al: Metabolic imaging in Parkinson disease. J Nucl Med. 58(1):23-8, 2017
                                                                                      6. Pagano G et al: Imaging in Parkinson's disease. Clin Med (Lond). 16(4):371-5, 2016
                                                                                      7. Booth TC et al: The role of functional dopamine-transporter SPECT imaging in parkinsonian syndromes, part 2. AJNR Am J Neuroradiol. 36(2):236-44, 2015
                                                                                      8. Goveas J et al: Diffusion-MRI in neurodegenerative disorders. Magn Reson Imaging. 33(7):853-76, 2015
                                                                                      9. Kalia LV et al: Parkinson's disease. Lancet. 386(9996):896-912, 2015
                                                                                      10. Broski SM et al: Structural and functional imaging in parkinsonian syndromes. Radiographics. 34(5):1273-92, 2014
                                                                                      11. Cosottini M et al: MR imaging of the substantia nigra at 7 T enables diagnosis of Parkinson disease. Radiology. 271(3):831-8, 2014
                                                                                      12. Brooks DJ et al: Imaging biomarkers in Parkinson's disease. Prog Neurobiol. 95(4):614-28, 2011
                                                                                      13. Wallis LI et al: MRI assessment of basal ganglia iron deposition in Parkinson's disease. J Magn Reson Imaging. 28(5):1061-7, 2008
                                                                                      14. Minati L et al: Imaging degeneration of the substantia nigra in Parkinson disease with inversion-recovery MR imaging. AJNR Am J Neuroradiol. 28(2):309-13, 2007
                                                                                      15. Oikawa H et al: The substantia nigra in Parkinson disease: proton density-weighted spin-echo and fast short inversion time inversion-recovery MR findings. AJNR Am J Neuroradiol. 23(10):1747-56, 2002