Imaging the Functional Neuroanatomy of Parkinson's Disease: Clinical Applications and Future Directions

Abstract

The neurobiology of Parkinson's disease and its progression has been investigated during the last few decades. Braak et al. proposed neuropathological stages of this disease based on the recognizable topographical extent of Lewy body lesions. This pathological process involves specific brain areas with an ascending course from the brain stem to the cortex. Post-mortem studies are of importance to better understand not only the progression of motor symptoms, but also the involvement of other domains, including cognition and behavior. The correlation between the neuropathological expansion of the disease and the clinical phases remains demanding. Neuroimaging, including magnetic resonance imaging (MRI), positron emission tomography (PET), and single photon emission computed tomography (SPECT), could help to bridge this existing gap by providing in vivo evidence of the extension of the disorders. In the last decade, we observed an overabundance of reports regarding the sensitivity of neuroimaging techniques. All these studies were aimed at improving the accuracy of Parkinson's disease (PD) diagnosis and discriminating it from other causes of parkinsonism. In this review, we look at the recent literature concerning PD and address the new frontier of diagnostic accuracy in terms of identification of early stages of the disease and conventional neuroimaging techniques that, in vivo, are capable of photographing the basal ganglia network and its cerebral connections.

Keywords: Parkinson’s disease; dopaminergic pathways; neuroimaging; older persons.

Figure 1

The fronto-striatal circuit (part a).

Figure 2

The fronto-striatal circuit (part b).

Figure 3

The fronto-striatal circuit (part c).

Figure 4

Types of Parkinson’s disease (PD) integrating motor and non-motor symptoms and fronto-striatal circuit alteration.