These radiotracers compete with endogenous dopamine to bind to the postsynaptic D2 receptors and show increased uptake within the putamen and, to a lesser extent, the caudate in patients with PD when compared with normal controls. The role of these tracers in the evaluation of patients with suspected PD may grow in the future. MR Spectroscopy Head There is no relevant literature to support the use of MR spectroscopy of the brain in the initial imaging evaluation of a patient with Parkinsonian syndrome. MRI Functional (fMRI) Head There is no relevant literature to support the use of fMRI of the brain in the initial imaging evaluation of a patient with Parkinsonian syndrome. MRI Head In patients with Parkinsonian syndrome, MRI of the brain without IV contrast is the optimal imaging modality because of its soft-tissue characterization and sensitivity to iron deposition [40-44]. Although IV contrast is not typically needed for the evaluation of Parkinsonian syndromes, it may be helpful for excluding additional differential considerations. Movement Disorders and Neurodegenerative Diseases In patients with CBD, MRI shows asymmetric atrophy of the frontal and parietal lobes, typically contralateral to the more affected side, as well as the striatum [42,57-60]. Faint T2/FLAIR hyperintensity can also be seen in the subcortical white matter in the atrophic regions, likely related to neuronal loss and gliosis [42,57,59,60]. In contrast to conventional MRI, advanced MRI may offer more meaningful and earlier diagnostic opportunities for patients with suspected PD and other Parkinsonian syndromes. For instance, 7-T MRI has shown promise in accurately differentiating healthy subjects from PD patients because it can demonstrate increased susceptibility in the substantia nigra and thinning of the pars compacta with blurring of the borders between the substantia nigra and red nucleus [66].
Movement Disorders and Neurodegenerative Diseases. These radiotracers compete with endogenous dopamine to bind to the postsynaptic D2 receptors and show increased uptake within the putamen and, to a lesser extent, the caudate in patients with PD when compared with normal controls. The role of these tracers in the evaluation of patients with suspected PD may grow in the future. MR Spectroscopy Head There is no relevant literature to support the use of MR spectroscopy of the brain in the initial imaging evaluation of a patient with Parkinsonian syndrome. MRI Functional (fMRI) Head There is no relevant literature to support the use of fMRI of the brain in the initial imaging evaluation of a patient with Parkinsonian syndrome. MRI Head In patients with Parkinsonian syndrome, MRI of the brain without IV contrast is the optimal imaging modality because of its soft-tissue characterization and sensitivity to iron deposition [40-44]. Although IV contrast is not typically needed for the evaluation of Parkinsonian syndromes, it may be helpful for excluding additional differential considerations. Movement Disorders and Neurodegenerative Diseases In patients with CBD, MRI shows asymmetric atrophy of the frontal and parietal lobes, typically contralateral to the more affected side, as well as the striatum [42,57-60]. Faint T2/FLAIR hyperintensity can also be seen in the subcortical white matter in the atrophic regions, likely related to neuronal loss and gliosis [42,57,59,60]. In contrast to conventional MRI, advanced MRI may offer more meaningful and earlier diagnostic opportunities for patients with suspected PD and other Parkinsonian syndromes. For instance, 7-T MRI has shown promise in accurately differentiating healthy subjects from PD patients because it can demonstrate increased susceptibility in the substantia nigra and thinning of the pars compacta with blurring of the borders between the substantia nigra and red nucleus [66].