Better neuroradiological approach for the diagnosis of early-stage Parkinson’s disease patients

In the development of the pathology of Parkinson’s disease (PD), neurodegeneration is already advanced when motor symptoms satisfying the diagnostic criteria of PD develop. Because conventional treatment with antiparkinsonian drugs is not disease-modifying therapy but provides only symptomatic relief, earlier diagnosis is required to treat patients more efficiently. The concept of prodromal PD was proposed as a paradigm shift in the diagnosis of PD. The core of this concept is the diagnosis made by risk assessment focusing on non-motor symptoms known to precede motor symptoms. These are closely related to abnormal findings in cardiac scintigraphy, transcranial sonography, and radiotracer imaging with a lack of motor symptoms. In addition, advances in magnetic resonance imaging technology are making it possible to visualize deep brain nuclei. Therefore, to perform these examinations for subjects at risk for developing PD, early diagnosis before the onset of motor symptoms is becoming realistic.