2024-01-25 08:05:01
The experts from the “Health and Prevention” blog, in a new post, delve into high-field magnetic resonance imaging, one of the technological advances against Parkinson’s.
Parkinson’s is a neurodegenerative disorder that affects the nervous system in a chronic and progressive manner. It is characterized by the progressive loss of dopaminergic neurons in the substantia nigra, an area of the brain involved in the control of movement.
It has a significant impact on the health and quality of life of both patients and their families and represents a great challenge for the health and social system, as it is also an incurable and disabling disease that requires follow-up. multidisciplinary, and individualized treatment.
Normally, the diagnosis is usually made when the disease is already advanced, although the latest imaging techniques are now making it possible to advance that moment and detect it in its most initial stages.
According to the Spanish Society of Neurology (SEN), Parkinson’s affects around 150,000 people in Spain, 0.3% of the total population, and 1% of those over 60 years of age. On average, about 10,000 new cases are diagnosed per year.
“It is the second most prevalent neurodegenerative disease today, after Alzheimer’s, and it is estimated that it will triple in the next 30 years due, in part, to the increase in life expectancy, and to diagnostic and therapeutic advances,” says the neuroradiologist doctor Juan Álvarez-Linera, head of the Diagnostic Imaging Service of the Ruber International Hospital of Madrid.
Diagnosis of Parkinson’s disease
Precisely, it highlights that in recent years the diagnosis of Parkinson’s disease has experienced notable technological advances, with the incorporation of advanced imaging techniques, such as functional magnetic resonance imaging and high-field magnetic resonance imaging, which have allowed more detailed visualization. of the brain changes associated with this pathology.
“High-field magnetic resonance imaging, which allows us to visualize, in greater detail than conventional techniques, structures related to Parkinson’s disease, such as the substantia nigra, the nigrosomes (areas of the substantia nigra), specifically the zona compacta, where dopaminergic cells and neuromelanin, a pigment found in the dopaminergic neurons of the substantia nigra, are very abundant,” details the doctor.
Generally, the diagnosis of Parkinson’s is clinical, continues the Ruber International expert, and this involves seeing what symptoms the patient associates (stiffness, tremor, alteration in gait or speech, for example), while a detailed evaluation is necessary. of your medical history, as well as a complete neurological examination, performed by a neurologist specializing in movement disorders.
Thus, this expert points out, when a person goes to the neurologist with symptoms, mainly tremor, several imaging tests are ordered. The first thing requested is an MRI to rule out other diseases that can mimic Parkinson’s disease, such as vascular lesions.
“When you do have the disease, the structural resonance is normally normal. But it is also the case in the case of essential tremor, a neurological disorder that causes involuntary and rhythmic movements of the hands, head, and other parts of the body, and that affects millions of people around the world,” the doctor points out.
“To discriminate between essential tremor and Parkinson’s disease – he points out – a ‘DatScan’ is requested, which is a functional test that involves the intravenous administration of a radiopharmaceutical that assesses the dopaminergic pathway, altered in Parkinson’s, and not in essential tremor. ”explains Juan Álvarez-Linera.
Neuroradiologist Juan Álvarez-Linera, head of the Diagnostic Imaging Service at the Ruber Internacional Hospital in Madrid.
High-field resonance against Parkinson’s, the latest
According to the head of the Diagnostic Imaging Service at the Ruber Internacional Hospital in Madrid, the most innovative techniques, such as high-field resonance, allow for early and more detailed identification of specific alterations in the substantia nigra, an area of the brain involved in control of movement, thus facilitating the distinction between Parkinson’s disease and essential tremor.
In more advanced MRIs, the magnetic field is greater than 1.5 Tesla, which is typical in the clinical environment and is equal to or greater than 3 Tesla. Precisely, the Ruber International Hospital has been the first European center to have 3 Tesla full-body for clinical use.
“It uses magnets with more powerful magnetic fields compared to those used in standard or conventional MRI. Even in our surrounding countries there are 7 Tesla magnets that are already used in the clinical environment, although in Spain there are still none. As the field increases, the detail is greater and the ability to see alterations also increases. But with 3 Teslas, the small changes in the brain that would mark the beginning of Parkinson’s are seen clearly enough,” he emphasizes.
“With high-field MRI we obtain high-resolution and higher contrast images. We also use different protocols or sequences in which we can modify some of its parameters and even fuse data from different sequences to obtain images that allow us to see lesions. or structural details that were not originally visible,” highlights the neuroradiologist.
But the doctor emphasizes that the future of Parkinson’s diagnosis lies not only in the use of 3 T or 7 T magnetic fields, but also in Artificial Intelligence (AI), thanks to which protocols in the fields of 3 T to be able to extract information in a more reliable and effective way.
Along these lines, Dr. Juan Álvarez-Linera affirms that, in a few years, any patient who begins to have symptoms suspicious of Parkinson’s will be able to undergo a high-field magnetic resonance imaging as screening, thus achieving an early diagnosis of the disease.
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