Lookup NU author(s): Professor Nicola Pavese
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Background Recent developments in Magnetic Resonance Imaging (MRI) techniques have offered new research opportunities to visualise in vivo substantia nigra pathology in Parkinson’s disease (PD). This paper summarizes the main findings of nigrosome imaging and neuromelanin sensitive MRI studies in patients with PD and other parkinsonisms. Methods The PubMed database was searched from 2005 to 2017 using the following keywords: Parkinson’s disease and Parkinsonism in combination with MRI, nigrosome, neuromelanin, and iron. Only publications in English were included. Results Nigrosome or dorsal nigral hyperintensity abnormalities are studied using T2* and susceptibility weight imaging MRI sequences in most studies, whereas Neuromelanin imaging is usually performed using T1-weighted fast spin echo sequence. Nigrosome abnormalities have been consistently demonstrated in PD patients, and nigrosome imaging has high sensitivity and specificity in distinguishing PD from healthy controls, though it is unable to reliably separate PD from atypical Parkinsonisms. Reduced neuromelanin-related signals and/or volume loss in neuromelanin containing structures have been found in PD patients, and neuromelanin sensitive MRI imaging can also discriminate PD patients from healthy controls with high accuracy, though there is a degree of heterogeneity in the imaging findings. Preliminary findings suggested that longitudinal change of neuromelanin signal can be detected in PD, raising the possibility of using it as a marker of disease progression. Conclusion Nigrosome imaging and neuromelanin sensitive MRI are promising tools to study nigral pathology and to improve the diagnosis of PD. However, further studies are required to standardise analysis approaches, confirm longitudinal changes and assess their generalisability.
Author(s): Pavese N, Tai YF
Publication type: Review
Publication status: Published
Journal: Movement Disorders Clinical Practice
Print publication date: 01/03/2018
Online publication date: 15/01/2018
Acceptance date: 24/12/2017
ISSN (electronic): 2330-1619