IMAGING PARKINSON'S DISEASE The Search for Biomarkers

摘要

One of the most compelling areas of Parkinson's disease imaging research focuses on the preclinical phase or patients in the early stages of the condition, says David Eidel-berg, MD, director of the Center for Neurosciences at the Feinstein Institute for Medical Research in Manhasset, N.Y. This is the time when treatment to slow progression is most important. "Just at the very point it's of greatest interest to intervene is when the clinical exam is probably weakest."Every patient suspected of having Parkinson's undergoes an MRI, though it mainly functions as a rule out test for non-Parkinson's conditions, such as structural lesions. Until the early 2000s, diagnosis hinged almost exclusively on clinical evaluation of symptoms. Enter dopamine active transporter (DAT) SPECT imaging, which has been increasing in clinical use since being approved in Europe in 2000 and by the FDA in 2011. DAT scans zero in on the major dopamine pathway from the substantia nigra and allow the visualization of the loss of dopaminergic cells, which have long been known to be part of Parkinson's pathology. These scans are useful in differentiating benign tremors from Parkinson's disease, says Eidelberg.