血管性帕金森病的神经影像学。
Neuroimaging in Vascular Parkinsonism.
机构信息
Division of Neurology, Department of Medicine and Therapeutics, Prince of Wales Hospital, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
Margaret K.L. Cheung Research Centre for Management of Parkinsonism, Gerald Choa Neuroscience Centre, Lui Che Woo Institute of Innovative Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
出版信息
Curr Neurol Neurosci Rep. 2019 Nov 26;19(12):102. doi: 10.1007/s11910-019-1019-7.
PURPOSE OF REVIEW
Being a disease with heterogeneous presentations and unclear consensus on its diagnostic criteria, it is difficult to differentiate vascular parkinsonism (VaP) from other neurodegenerative parkinsonism variants. Ongoing research on structural and functional neuroimaging targeting dopaminergic pathway provides us more insight into the pathophysiology of VaP to improve diagnostic accuracy. The aim of this article is to review how the emerging imaging modalities help the diagnostic process and treatment decision in VaP.
RECENT FINDINGS
Dopamine transporter imaging is a promising tool in differentiating presynaptic parkinsonism and VaP. It also predicts the levodopa responders in VaP. Advanced MRI techniques including volumetry, diffusion tensor imaging and sequences visualising substantia nigra are under development, and they are complementary to each other in detecting structural and functional changes in VaP, which is crucial to ensure the quality of future therapeutic trials for VaP. Dopamine transporter imaging is recommended to patients with suspected VaP. Multimodal MRI in VaP would be an important area to be investigated in the near future.
目的综述
血管性帕金森病（VaP）临床表现多样，其诊断标准尚不明确，因此难以与其他神经退行性帕金森病变异区分。针对多巴胺能通路的结构和功能神经影像学的研究为 VaP 的病理生理学提供了更深入的了解，以提高诊断准确性。本文旨在综述新兴影像学手段如何帮助 VaP 的诊断过程和治疗决策。
最近的发现
多巴胺转运体成像在区分前突触帕金森病和 VaP 方面是一种很有前途的工具。它还可以预测 VaP 对左旋多巴的反应。先进的 MRI 技术，包括体积测量、弥散张量成像和黑质成像序列，正在开发中，它们在检测 VaP 的结构和功能变化方面相互补充，这对于确保未来 VaP 治疗试验的质量至关重要。建议疑似 VaP 的患者进行多巴胺转运体成像。多模态 MRI 在 VaP 中的应用将是未来研究的一个重要领域。
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