Neuroimaging in Atypical Parkinsonian Disorders

M. Ollivier, D. Leclercq, M.O. Habert, D. Dormont, B. Law-ye, S. Lehericy, and N. Pyatigorskaya

View Article on Neurographics Website

Date of Activity Release: Jun. 1, 2018
Date of Activity Expiration: Jun. 1, 2021

Target Audience:
Intended for neuroradiologists and neuroradiology trainees with varying degrees of experience.

Learning Objective:
To recognize the conventional MR findings for each atypical parkinsonian disorder and to know the advanced MR imaging techniques and radiotracers that are useful in the differentiation of atypical parkinsonism in clinical practice.

Atypical parkinsonian disorders are a heterogeneous group of neurodegenerative diseases that include progressive supranuclear palsy, multiple system atrophy, and corticobasal degeneration. In early disease stages, symptoms often overlap, and it may be difficult to distinguish these entities and to differentiate them from idiopathic Parkinson disease solely by clinical examination. Conventional MR imaging as well as advanced MR imaging techniques and PET/SPECT imaging are helpful tools to enhance the accuracy of clinical diagnosis in these disorders. The aim of this review was (1) to present and discuss the relevance of advanced MR imaging techniques (voxel-based morphometry, iron-sensitive MR imaging, DTI, spectroscopy) and to present the radiotracer imaging techniques and (2) to define the different types of atypical parkinsonian disorders, summarize the most important radiologic findings of conventional MR imaging for each atypical parkinsonian disorder, show the usefulness of advanced MR imaging techniques in clinical practice, and present the radiotracer imaging findings. Conventional MR imaging can contribute to differentiating atypical parkinsonian disorders from each other and from Parkinson disease, showing specific patterns of atrophy combined with classic patterns of T2 signal intensity change in the basal ganglia, pons, and middle and superior cerebellar peduncles. Advanced MR imaging sequences and radiotracer imaging may be most helpful in the early diagnosis of atypical parkinsonian disorders.

Commercial Support
No commercial support was received for this activity.

Credit Designation Statement

The American Society of Neuroradiology is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The American Society of Neuroradiology designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 Credit(s)TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Method of Physician Participation:
Each participant will review the corresponding Neurographics article located at Upon completion, each physician will complete and pass a post-test with a score of at least 80% to receive a CME certificate.

All individuals in control of content have disclosed the following relevant financial relationships. All of these relationships were treated as a conflict of interest, and have been resolved (C7 SCS 6.1-6.2, 6.5)

Authors have no relevant financial relationships.





Barton Branstetter 

Editor in Chief

None, N/A

Adam Flanders

Deputy Editor

Royalties, Lippincott Williams and Wilkins

Robert Quencer 

Consulting Editor

None, N/A

Mark Mullins

Associate Editor

Non-remunerative position, AUR6

Meng Law

Associate Editor

Stockholder, Clinical Imaging

Edward Escott

Associate Editor

Grant, Atherysys, Inc.; Royalties, Thieme Medical Publishers

Scott Faro

Associate Editor

None, N/A

Tina Young Poussaint

Associate Editor

None, N/A

Dheeraj Ghandi

Associate Editor

Grant, Arstasis, Axera Inc.; Consultant, Covidien, EV3

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