U Walter1, H Zach2,3, I Liepelt-Scarfone4, W Maetzler5. 1. Klinik und Poliklinik für Neurologie, Universitätsmedizin Rostock, Rostock, Deutschland. 2. Universitätsklinik für Neurologie, Medizinische Universität Wien, Wien, Österreich. 3. Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Radboud University Medical Centre, Nijmegen, Niederlande. 4. Hertie Institut für klinische Hirnforschung, Universität Tübingen und Deutsches Zentrum für Neurodegenerative Erkrankungen, Tübingen, Deutschland. 5. Klinik für Neurologie, Universitätsklinikum Schleswig-Holstein, Arnold-Heller-Straße 3, 24105, Kiel, Deutschland. w.maetzler@neurologie.uni-kiel.de.
Abstract
BACKGROUND: The clinical diagnosis of idiopathic Parkinson's disease (iPD) can be challenging. In these cases, additional diagnostic methods are available that can help to improve diagnostic accuracy. OBJECTIVES, MATERIAL AND METHODS: This article provides an overview of currently available and promising novel ancillary methods for the early and differential diagnosis of iPD. RESULTS: Imaging tools, such as 1.5 Tesla magnetic resonance imaging (MRI) and computed tomography (CT) are mainly used for the differentiation between iPD and symptomatic parkinsonian syndromes (PS). High-resolution diffusion tensor imaging and iron and neuromelanin-sensitive high-field MRI sequences can become important in the future, particularly for earlier diagnosis. Transcranial B‑mode sonography of the substantia nigra and basal ganglia is established for early and differential diagnostics, especially in the combination of diagnostic markers but necessitates an adequately trained investigator and the use of validated digital image analysis instruments. DATScan can discriminate iPD from essential tremor, medication-induced parkinsonism and psychogenic movement disorder but not iPD from atypical PS. For the latter differential diagnosis, fluorodeoxyglucose positron emission tomography and myocardial metaiodobenzylguanidine scintigraphy can be helpful. Olfactory testing should preferably be used in combination with other diagnostic tests. Genetic, biochemical and histopathological tests are currently not recommended for routine use. Novel sensor-based techniques have a high potential to support clinical diagnosis of iPD but have not yet reached a developmental stage that is sufficient for clinical use. Novel sensor-based techniques have high potential to support clinical diagnosis of iPD, but have not yet reached a development stage that is sufficient for clinical use. CONCLUSION: Ancillary diagnostic methods can support the early and differential diagnosis of iPD.
BACKGROUND: The clinical diagnosis of idiopathic Parkinson's disease (iPD) can be challenging. In these cases, additional diagnostic methods are available that can help to improve diagnostic accuracy. OBJECTIVES, MATERIAL AND METHODS: This article provides an overview of currently available and promising novel ancillary methods for the early and differential diagnosis of iPD. RESULTS: Imaging tools, such as 1.5 Tesla magnetic resonance imaging (MRI) and computed tomography (CT) are mainly used for the differentiation between iPD and symptomatic parkinsonian syndromes (PS). High-resolution diffusion tensor imaging and iron and neuromelanin-sensitive high-field MRI sequences can become important in the future, particularly for earlier diagnosis. Transcranial B‑mode sonography of the substantia nigra and basal ganglia is established for early and differential diagnostics, especially in the combination of diagnostic markers but necessitates an adequately trained investigator and the use of validated digital image analysis instruments. DATScan can discriminate iPD from essential tremor, medication-induced parkinsonism and psychogenic movement disorder but not iPD from atypical PS. For the latter differential diagnosis, fluorodeoxyglucose positron emission tomography and myocardial metaiodobenzylguanidine scintigraphy can be helpful. Olfactory testing should preferably be used in combination with other diagnostic tests. Genetic, biochemical and histopathological tests are currently not recommended for routine use. Novel sensor-based techniques have a high potential to support clinical diagnosis of iPD but have not yet reached a developmental stage that is sufficient for clinical use. Novel sensor-based techniques have high potential to support clinical diagnosis of iPD, but have not yet reached a development stage that is sufficient for clinical use. CONCLUSION: Ancillary diagnostic methods can support the early and differential diagnosis of iPD.
Entities:
Keywords:
Differential diagnosis; Essential tremor; Movement disorder; Multisystem atrophy; Substantia nigra
Authors: Daniela Berg; Ronald B Postuma; Charles H Adler; Bastiaan R Bloem; Piu Chan; Bruno Dubois; Thomas Gasser; Christopher G Goetz; Glenda Halliday; Lawrence Joseph; Anthony E Lang; Inga Liepelt-Scarfone; Irene Litvan; Kenneth Marek; José Obeso; Wolfgang Oertel; C Warren Olanow; Werner Poewe; Matthew Stern; Günther Deuschl Journal: Mov Disord Date: 2015-10 Impact factor: 10.338
Authors: M B Aerts; R A J Esselink; W F Abdo; F J A Meijer; G Drost; N Norgren; M J R Janssen; G F Borm; B R Bloem; M M Verbeek Journal: J Neurol Date: 2014-11-09 Impact factor: 4.849
Authors: Julio Acosta-Cabronero; Arturo Cardenas-Blanco; Matthew J Betts; Michaela Butryn; Jose P Valdes-Herrera; Imke Galazky; Peter J Nestor Journal: Brain Date: 2016-11-11 Impact factor: 13.501
Authors: Peggy J Planetta; Edward Ofori; Ofer Pasternak; Roxana G Burciu; Priyank Shukla; Jesse C DeSimone; Michael S Okun; Nikolaus R McFarland; David E Vaillancourt Journal: Brain Date: 2015-12-24 Impact factor: 13.501
Authors: Daniela Berg; Stefanie Behnke; Klaus Seppi; Jana Godau; Stefanie Lerche; Philipp Mahlknecht; Inga Liepelt-Scarfone; Christoph Pausch; Niko Schneider; Alexandra Gaenslen; Kathrin Brockmann; Karin Srulijes; Heiko Huber; Isabel Wurster; Heike Stockner; Stefan Kiechl; Johann Willeit; Arno Gasperi; Klaus Fassbender; Thomas Gasser; Werner Poewe Journal: Mov Disord Date: 2012-10-31 Impact factor: 10.338
Authors: Alexandra Gaenslen; Barbara Unmuth; Jana Godau; Inga Liepelt; Adriana Di Santo; Katherine Johanna Schweitzer; Thomas Gasser; Hans-Jürgen Machulla; Matthias Reimold; Kenneth Marek; Daniela Berg Journal: Lancet Neurol Date: 2008-04-03 Impact factor: 44.182