Magnetic Resonance Imaging in Neurodegenerative Parkinsonian Disorders
Summary
Magnetic resonance imaging (MRI) has emerged as a cornerstone in the evaluation of Parkinsonian syndromes by enabling non-invasive characterisation of brain structure and pathology. Beyond routine clinical scans, advanced quantitative approaches permit detailed assessment of the brainstem, basal ganglia and associated white-matter tracts. Planimetric measurements of the midbrain and pons, together with derived indices such as the Magnetic Resonance Parkinsonism Index, offer objective markers to distinguish idiopathic Parkinson’s disease from atypical parkinsonisms including multiple system atrophy, progressive supranuclear palsy and corticobasal degeneration. Innovations in automated segmentation and shape analysis yield reproducible volumetric and morphometric data that correlate with clinical severity and fluid biomarkers of neuronal injury. Complementary modalities—such as diffusion-weighted imaging, neuromelanin-sensitive sequences and iron-contrast techniques—provide further insight into microstructural changes, iron deposition and neurochemical alterations. Standardisation of acquisition protocols and the integration of machine-learning algorithms promise to enhance diagnostic accuracy across research and clinical centres. While overlapping imaging features in early disease remain a challenge, multimodal MRI continues to advance our understanding of disease heterogeneity, support timely diagnosis and serve as a platform for monitoring progression and response to emerging therapies.
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Magnetic Resonance Imaging in Neurodegenerative Parkinsonian Disorders publication trend
The graph below shows the total number of articles in magnetic resonance imaging in neurodegenerative parkinsonian disorders across all publications each year (not limited to Nature Index journals).
Technical terms
Planimetry: Quantitative measurement of brain regions on MRI using surface or area calculations.
Magnetic Resonance Parkinsonism Index (MRPI): A composite ratio of pons and midbrain dimensions used to differentiate atypical parkinsonian syndromes.
Midbrain-to-Pons Ratio: The ratio of midsagittal dimensions of the midbrain and pons, employed as a simple marker for progressive supranuclear palsy.
Neurofilament-Light Chain (NfL): A fluid biomarker reflecting neuronal degeneration that can correlate with imaging measures.
Automated Segmentation: Computerised delineation of anatomical structures on MRI to provide reproducible volumetric data.
References
- Midbrain and pons MRI shape analysis and its clinical and CSF correlates in degenerative parkinsonisms: a pilot study. European Radiology (2023).
- MRI Planimetry and Magnetic Resonance Parkinsonism Index in the Differential Diagnosis of Patients with Parkinsonism. American Journal of Neuroradiology (2018).
- The midbrain to pons ratio. Neurology (2013).
- Fully Automated Segmentation of the Pons and Midbrain Using Human T1 MR Brain Images. PLOS ONE (2014).
- Brainstem atrophy in dementia with Lewy bodies compared with progressive supranuclear palsy and Parkinson’s disease on MRI. BMC Neurology (2023).
- Magnetic resonance imaging modalities aid in the differential diagnosis of atypical parkinsonian syndromes. Frontiers in Neurology (2023).
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