MRI for the differential diagnosis of neurodegenerative parkinsonism in clinical practice
MRI for the differential diagnosis of neurodegenerative parkinsonism in clinical practice
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DOI：
10.1016/s1353-8020(08)70038-5
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发表时间：
2007-01-01
影响因子：
4.1
通讯作者：
Seppi, Klaus
中科院分区：
文献类型：
--
作者：
Seppi, Klaus
帕金森病（PD）是帕金森病最常见的神经退行性病因，其次是进行性核上性麻痹（PSP）和多系统萎缩（MSA）。尽管PD和各种非典型帕金森病（APD）（如PSP、MSA和皮质基底变性）的诊断有共识的操作标准，但神经退行性帕金森综合征的准确诊断仍然是每个神经科医生面临的挑战。特别是在疾病的早期阶段，apd和PD的临床分离有很高的误诊率。然而，APD和PD的早期鉴别对于确定预后和选择治疗策略至关重要，因为两者具有完全不同的自然历史特征。MRI在排除由其他病理引起的症状性帕金森病方面起着重要作用。在过去的二十年里，传统的MRI和先进的MRI技术，包括质子磁共振波谱（H-1-MRS）、扩散加权成像（DWI）、磁化转移成像（MTI）和磁共振体积测量（MRV）都显示出黑质和基底节区的异常，特别是在APD中。此外，根据神经病理学研究表明嗅觉系统是疾病的早期靶点，最近使用先进的MRI技术的研究显示，PD患者的早期疾病阶段嗅觉系统异常。鉴于嗅觉缺陷可能是该疾病的前运动标志物，这些方法可能最终演变成PD的早期筛查工具。(c) 2007 Elsevier B.V.版权所有
Parkinson's disease (PD) is the most common neurodegenerative cause of parkinsonism, followed by progressive supranuclear palsy (PSP) and multiple system atrophy (MSA). Despite the publication of consensus operational criteria for the diagnosis of PD and the various atypical parkinsonian disorders (APD) such as PSP, MSA and corticobasal degeneration, an accurate diagnosis of neurodegenerative parkinsonian syndromes remains a challenge for each neurologist. Particularly in the early disease stages the clinical separation of APDs from PD carries a high rate of misdiagnosis. However, an early differentiation between APD and PD, each characterized by completely different natural histories, is crucial for determining the prognosis and choosing a treatment strategy. MRI plays an important role in the exclusion of symptomatic parkinsonism due to other pathologies. Over the past two decades, conventional MRI and advanced MRI techniques, including proton magnetic resonance spectroscopy (H-1-MRS), diffusion-weighted imaging (DWI), magnetization transfer imaging (MTI), and magnetic resonance volumetry (MRV) have shown abnormalities in the substantia nigra and basal ganglia, especially in APD. Furthermore, in accordance with neuropathological studies suggesting that the olfactory system is an early target of the disease, recent studies using advanced MRI techniques have shown abnormalities in the olfactory system in the early disease stages of patients with PD. Given that olfactory deficits may be a premotor marker of the disease, such methods may eventually evolve into an early screening tool for PD. (c) 2007 Elsevier B.V. All rights reserved.