The SNUBH team publishes a review article on Parkinson’s disease in a global journal

A group of Korean researchers recently published a comprehensive thesis on Parkinson’s disease and Parkinson’s syndrome which compiled all the findings from associated brain magnetic resonance images, attracting the attention of the medical community.

In the substantia nigra of a healthy person (left) and patients with Parkinson’s disease, the dark shadows show the loss of dopamine.

The dissertation, written by Professors Bae Yun-jung and Kim Jong-min of Bundang Hospital at Seoul National University, is important as a global review of imaging biomarkers for Parkinson’s disease, said Tuesday the hospital.

Parkinson’s disease is a common neurodegenerative disease caused by the loss of dopamine-producing cells in the substantia nigra (SN) of the midbrain. Symptoms include slow movements, muscle changes or stiffness, and postural instability.

Health care professionals diagnose Parkinson’s disease by looking for symptoms and doing a neurological exam. However, to distinguish it from parkinsonism or secondary parkinsonism, they need medical imaging tests like MRI.

The SNUBH review thesis compiled all recent findings on black imaging, one of the imaging biomarkers used for the diagnosis of Parkinson’s disease. The thesis includes the imaging of the trajectories and orientations of fibers of dopaminergic neurons in the brain. These are nigrosome imaging, neuromelanin imaging, quantitative iron mapping, and diffusion tensor imaging.

The article also explains the brain volume associated with symptoms of Parkinson’s disease and Parkinson’s syndrome.

To diagnose Parkinson’s disease, imaging of the structural change in substantia nigra using various MRI techniques is important. In the past, it was difficult to observe the detailed structure of the SN with a previous MRI. However, the advent of dense 3-T and 7-T sensitivity-weighted imaging screening has allowed them to be photographed in greater detail. (T stands for Tesla, and the higher the following number, the higher the resolution of the image.)

By visualizing the nigrosome, the affected area of ​​the brain, and identifying areas of cell loss, an accurate diagnosis became possible.

Another way to diagnose Parkinson’s disease is by looking at the distribution of neuromelanin (NM). NM is a neuroprotective substance produced with the secretion of dopamine in the substantia nigra. Through dense observation of ND using MRI, the change in the amount of dopamine in the brain could be detected to diagnose Parkinson’s disease.

Neuromelanin accumulates in neurons. If neurons are lost due to Parkinson’s disease, NMs disappear together. Therefore, by observing the amount of NM, the amount of dopamine secretion could be found, which helps in the diagnosis of early stage Parkinson’s disease and its prognosis during treatment.

In addition, the use of MRI to analyze the distribution of iron in the brain is also useful for the diagnosis of Parkinson’s disease. The NM distributed over the substantia nigra have the characteristic of retaining the irons entering the brain. The problem arises when the amount of iron found in the substantia nigra exceeds the amount that NMs can retain. The iron accumulated on the SN is known to stress brain tissue and kill cells. Therefore, iron overload in the SN can lead to Parkinson’s disease.

Through diffusion tensor imaging (DTI), structural changes in the brain could be detected to make a diagnosis. For example, patients with Parkinson’s disease tend to show more loss of SN volume.

Professors Kim Jong-min (left) from the Department of Neurology and Bae Yun-jung from the Department of Radiology at Bundang Hospital, Seoul National University
Professors Kim Jong-min (left) from the Department of Neurology and Bae Yun-jung from the Department of Radiology at Bundang Hospital, Seoul National University

“A simple MRI test has a high rate of utility as a biomarker to detect underlying changes.” said Professor Bae. “With a variety of imaging techniques, observing the structural change in the brain and the distribution and number of neuronal substances in the brain can help diagnose the early stage of Parkinson’s disease. Additionally, it could be useful for prevention and treatment plans. “

Professor Kim also said: “MRI imaging which has been overlooked as a means of diagnosis, treatment and long-term observation has proven to be useful. Thus, its importance was again underlined. With the development of radiology, the diagnosis of early Parkinson’s disease became possible. Therefore, if you have symptoms of slow movement and tremors, do not consider it a sign of aging, but please go to a nearby hospital.

The article was published online in Radiology, a global journal in the field.

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