Parkinson’s disease is a neurodegenerative condition characterized by the progressive death of nerve cells in the brain. The typical symptoms of Parkinson’s disease — tremors, slowness of movement, muscle stiffness, and balance issues — are used to diagnose the condition.
However, there are other things such as a stroke or a brain tumor that can mimic the symptoms of Parkinson’s disease. Magnetic resonance imaging (MRI) of the brain is primarily used to rule out these other possibilities.
MRI uses radio waves and a powerful magnetic field to produce detailed images of organs and tissues.
Unlike other imaging techniques, MRI does not expose patients to harmful radiation. It is safe and painless.
In addition to helping with the diagnosis of Parkinson’s disease, an MRI can also be used for the guided placement of electrodes into the brain for deep brain stimulation — a surgical treatment for Parkinson’s disease that helps control tremors and involuntary movements.
In preparation for the scanning, the patient will be asked to put on loose-fitting scrubs. The patient will be asked to lie on the scanner table, which will be moved into the scanner tunnel for imaging.
The patient is required to lie still during the procedure, as movement will affect the quality of the image. Parkinson’s disease patients may be sedated during the procedure to ensure that tremors do not interfere with the scan. The radiologists should be informed about any medication the patient is taking; some medications may need to be discontinued before imaging. Similarly, if deep brain stimulation is being used, the radiologist must be informed as it may be advised to stop the stimulation prior to scanning.
A dye is sometimes used to produce more detailed images of the brain. The decision to perform an MRI with a dye (called contrast MRI) is made after discussions with the care team. For this type of MRI, the dye is injected into the bloodstream, then travels to the brain to highlight the blood vessels.
The scanning process takes between 45 minutes and an hour to image several sections of the brain. Contrast MRI may take longer. During scanning, the machine makes loud banging and muffled thumping sounds. This is normal and does not interfere with the imaging.
There are giant magnets in the MRI scanners; exams are not recommended for patients with pacemakers, metal implants, certain tattoos, or shrapnel.
Brain MRI advances for Parkinson’s disease
In Parkinson’s disease, the damage to brain cells begins long before any symptoms develop. Therefore, at-risk patients can benefit from early diagnosis, and efforts to slow the progression of the disease can start early.
Researchers are working on newer MRI approaches to precisely detect Parkinson’s disease-related structural and metabolic activity in the brain and correlate it to the function of the organ. For example, scientists from Oxford University used a technique called the resting-state functional MRI (fMRI) to assess the strength of nerve cells in the a region of the brain called the basal ganglia to send and receive information. Because the physical signs of brain cell damage in Parkinson’s disease are not recognizable by conventional MRI, this approach may help visualize the impact of the damage on the activity of brain cells and aid in early diagnosis.
Similarly, MRI is used to identify Parkinson’s disease-specific biomarkers. Tracking the biomarkers using high-field and ultra-high field MRI can identify Parkinson’s disease patients and help follow the progression of the condition.
Although many of these advancements are yet to be implemented in the clinical setting, such adaptations may help better understand the disease and develop new treatments.
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