RT Journal Article
SR Electronic
T1 Atypical Parkinsonian Syndromes: Structural, Functional, and Molecular Imaging Features
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 1865
OP 1877
DO 10.3174/ajnr.A8313
VO 45
IS 12
A1 Keir, Graham
A1 Roytman, Michelle
A1 Mashriqi, Faizullah
A1 Shahsavarani, Shaya
A1 Franceschi, Ana M.
YR 2024
UL http://www.ajnr.org/content/45/12/1865.abstract
AB SUMMARY: Atypical parkinsonian syndromes, also known as Parkinson-plus syndromes, are a heterogeneous group of movement disorders, including dementia with Lewy bodies (DLB), progressive supranuclear palsy (PSP), multisystem atrophy (MSA), and corticobasal degeneration (CBD). This review highlights the characteristic structural, functional, and molecular imaging features of these complex disorders. DLB typically demonstrates parieto-occipital hypometabolism with involvement of the cuneus on FDG-PET, whereas dopaminergic imaging, such as [123I]-FP-CIT SPECT (DaTscan) or fluorodopa (FDOPA)-PET, can be utilized as an adjunct for diagnosis. PSP typically shows midbrain atrophy on structural imaging, whereas FDG-PET may be useful to depict frontal lobe hypometabolism and tau-PET confirms underlying tauopathy. MSA typically demonstrates putaminal or cerebellar atrophy, whereas FDG-PET highlights characteristic nigrostriatal or olivopontocerebellar hypometabolism, respectively. Finally, CBD typically shows asymmetric atrophy in the superior parietal lobules and corpus callosum, whereas FDG and tau-PET demonstrate asymmetric hemispheric and subcortical involvement contralateral to the side of clinical deficits. Additional advanced neuroimaging modalities and techniques described may assist in the diagnostic work-up or are promising areas of emerging research.3D-SSP3D stereotactic surface projectionADAlzheimer diseaseASLarterial spin-labelingAPSatypical parkinsonian syndromeCBDcorticobasal degenerationCBScorticobasal syndromeCIScingulate island signDaTdopamine transporterDaTscan[123I]-FP-CIT SPECTDIPdrug-induced parkinsonismDLBdementia with Lewy bodiesFAfractional anisotropyFDOPAfluorodopaMCPmiddle cerebellar peduncleMSAmultisystem atrophyMSA-Cmultisystem atrophy–cerebellarMSA-Pmultisystem atrophy–parkinsonianPAposterior atrophyPDParkinson diseasePSPprogressive supranuclear palsyrCBFregional cerebral blood flowrs-fMRIresting-state functional MR imagingRSNresting-state networkSCPsuperior cerebellar peduncleSMAsupplementary motor areaVaPvascular parkinsonism