University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Nuclear Medicine, Multimodal Neuroimaging Group, Cologne, Germany.
University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Neurology, Cologne, Germany.
J Parkinsons Dis. 2024;14(s2):S353-S365. doi: 10.3233/JPD-230385.
Assessing imaging biomarker in the prodromal and early phases of Parkinson's disease (PD) is of great importance to ensure an early and safe diagnosis. In the last decades, imaging modalities advanced and are now able to assess many different aspects of neurodegeneration in PD. MRI sequences can measure iron content or neuromelanin. Apart from SPECT imaging with Ioflupane, more specific PET tracers to assess degeneration of the dopaminergic system are available. Furthermore, metabolic PET patterns can be used to anticipate a phenoconversion from prodromal PD to manifest PD. In this regard, it is worth mentioning that PET imaging of inflammation will gain significance. Molecular imaging of neurotransmitters like serotonin, noradrenaline and acetylcholine shed more light on non-motor symptoms. Outside of the brain, molecular imaging of the heart and gut is used to measure PD-related degeneration of the autonomous nervous system. Moreover, optical coherence tomography can noninvasively detect degeneration of retinal fibers as a potential biomarker in PD. In this review, we describe these state-of-the-art imaging modalities in early and prodromal PD and point out in how far these techniques can and will be used in the future to pave the way towards a biomarker-based staging of PD.
评估帕金森病（PD）前驱期和早期的影像学生物标志物对于确保早期和安全诊断非常重要。在过去的几十年中，成像方式不断发展，现在能够评估 PD 中许多不同的神经退行性变方面。MRI 序列可以测量铁含量或神经黑色素。除了 Ioflupane 的 SPECT 成像外，还有更具体的 PET 示踪剂可用于评估多巴胺能系统的退化。此外，代谢 PET 模式可用于预测前驱期 PD 向显性病 PD 的表型转化。在这方面，值得一提的是，炎症的 PET 成像将变得重要。神经递质如 5-羟色胺、去甲肾上腺素和乙酰胆碱的分子成像为非运动症状提供了更多信息。在大脑之外，心脏和肠道的分子成像用于测量与 PD 相关的自主神经系统退化。此外，光学相干断层扫描可以无创地检测视网膜纤维的退化，作为 PD 的潜在生物标志物。在这篇综述中，我们描述了早期和前驱 PD 中的这些最先进的成像方式，并指出这些技术在未来可以在多大程度上用于为 PD 的基于生物标志物的分期铺平道路。
