Reply to: “Experience with a New Index to Differentiate Parkinson's Disease and Progressive Supranuclear Palsy”

Quattrone, Andrea; Antonini, Angelo; Vaillancourt, David E.; Seppi, Klaus; Ceravolo, Roberto; Strafella, Antonio P.; Quattrone, Aldo

doi:10.1002/mds.28725

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“…Isolated third ventricle enlargement can also independently differentiate PSP from PD and can be easily implemented into clinical practice as it does not require research-specific expertise to reconstruct the images for the MRPI calculation. 64 A midbrain-to-pons ratio less than 0.21 can also identify PSP from MSA. The MDS-PSP Study Group has acknowledged the reliability of the MRPI and midbrain-to-pons ratio in the diagnosis of PSP-RS in early and late disease stages, so this may be implemented into clinical practice in the near future.…”

Section: Clinically Accessible Imaging Modalities In Atypical Parkins...mentioning

confidence: 99%

Structural and Molecular Imaging for Clinically Uncertain Parkinsonism

Sasikumar

Strafella

2023

Semin Neurol

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Neuroimaging is an important adjunct to the clinical assessment of Parkinson disease (PD). Parkinsonism can be challenging to differentiate, especially in early disease stages, when it mimics other movement disorders or when there is a poor response to dopaminergic therapies. There is also a discrepancy between the phenotypic presentation of degenerative parkinsonism and the pathological outcome. The emergence of more sophisticated and accessible neuroimaging can identify molecular mechanisms of PD, the variation between clinical phenotypes, and the compensatory mechanisms that occur with disease progression. Ultra-high-field imaging techniques have improved spatial resolution and contrast that can detect microstructural changes, disruptions in neural pathways, and metabolic and blood flow alterations. We highlight the imaging modalities that can be accessed in clinical practice and recommend an approach to the diagnosis of clinically uncertain parkinsonism.

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Section: Clinically Accessible Imaging Modalities In Atypical Parkins...mentioning

confidence: 99%