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Table 1.  

Differential Imaging Findings in Parkinsonian Syndromes

Table 2.  

Differential Imaging Findings in Dementias

Technology Insight: Imaging Neurodegeneration in Parkinson's Disease: Key Points


Key Points

  • Structural changes in the substantia nigra can be imaged with both transcranial sonography and MRI in patients with Parkinson's disease (PD), and are valuable for revealing susceptibility to PD
  • PET and single-photon emission CT measurements of dopamine terminal function are able to sensitively detect dopamine deficiency in both symptomatic patients and individuals at risk for parkinsonian syndromes; a normal scan in a patient suspected of having PD implies a good prognosis
  • Depression in PD does not seem to be of a serotonergic etiology; rather, it reflects a loss of noradrenergic and limbic monoaminergic function
  • Dementia with Lewy bodies can be reliably discriminated from Alzheimer’s disease by the detection of a loss of striatal dopamine transporter binding in the former
  • The majority of patients who have dementia with Lewy bodies have a substantial amyloid-β load, but this is rare in PD patients with late dementia
  • Atypical PD can be most sensitively discriminated from PD by use of Diffusion-weighted MRI or 18F-fluoro-2-deoxyglucose PET
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