Detalle Publicación

Multimodal brain and retinal imaging of dopaminergic degeneration in parkinson disease

Autores: Lee, J. Y. (Autor de correspondencia); Martin Bastida, Antonio; Murueta-Goyena, A.; Gabilondo, I.; Cuenca, N.; Piccini, P.; Jeon, B.
Título de la revista: NATURE REVIEWS NEUROLOGY
ISSN: 1759-4758
Volumen: 18
Número: 4
Páginas: 203 - 220
Fecha de publicación: 2022
Parkinson disease (PD) is a progressive disorder characterized by dopaminergic neurodegeneration in the brain. The development of parkinsonism is preceded by a long prodromal phase, and >50% of dopaminergic neurons can be lost from the substantia nigra by the time of the initial diagnosis. Therefore, validation of in vivo imaging biomarkers for early diagnosis and monitoring of disease progression is essential for future therapeutic developments. PET and single-photon emission CT targeting the presynaptic terminals of dopaminergic neurons can be used for early diagnosis by detecting axonal degeneration in the striatum. However, these techniques poorly differentiate atypical parkinsonian syndromes from PD, and their availability is limited in clinical settings. Advanced MRI in which pathological changes in the substantia nigra are visualized with diffusion, iron-sensitive susceptibility and neuromelanin-sensitive sequences potentially represents a more accessible imaging tool. Although these techniques can visualize the classic degenerative changes in PD, they might be insufficient for phenotyping or prognostication of heterogeneous aspects of PD resulting from extranigral pathologies. The retina is an emerging imaging target owing to its pathological involvement early in PD, which correlates with brain pathology. Retinal optical coherence tomography (OCT) is a non-invasive technique to visualize structural changes in the retina. Progressive parafoveal thinning and fovea avascular zone remodelling, as revealed by OCT, provide potential biomarkers for early diagnosis and prognostication in PD. As we discuss in this Review, multimodal imaging of the substantia nigra and retina is a promising tool to aid diagnosis and management of PD. In vivo imaging biomarkers for early diagnosis and monitoring of Parkinson disease (PD) are important for the development of new therapies. The authors review recent advances in brain and retinal imaging in PD, focusing particularly on multimodal approaches with applications at the prodromal stage.