by It is estimated that between 120,000 and 150,000 people suffer from Parkinson’s in Spain, a tneurodegenerative disorder that affects the nervous system in a chronic and progressive way, and that belongs to the so-called Movement Disorders. It is the second most prevalent neurodegenerative disease today, behind Alzheimer’s, and each year about 10,000 new cases are diagnosed in our country.
Additionally, it takes an average of one to three years for patients to receive a diagnosis, and up to 25% of people diagnosed are thought to actually have another illness. As the doctor points out Juan Alvarez Linera Pradochief neuroradiologist Diagnostic Imaging Service of the Ruber International Hospital, «the progressive loss of dopaminergic neurons is responsible for the symptoms of Parkinson’s disease, among which tremor, rigidity, slowness of movement and postural instability stand out. Other non-motor symptoms may also appear, such as depression, sleep disorders, cognitive problems or smell disorders.
Today, thanks to the most recent techniques, it is possible. identifyearly, specific alterations in the substantia nigra, an area of the brain involved in the control of movement, thus facilitating the distinction between Parkinson’s Disease (PD) and essential tremor. The latter is characterized by the patient suffering from rhythmic movement or tremor in the hands, head, trunk, legs, and it can even affect the voice.
Between the techniques toe caps highlight the high field MRI, a novel technology that uses magnets with more powerful magnetic fields compared to those used in standard or conventional MRI. According to Dr. Álvarez-Linera, in medicine, a magnetic field of 1.5 Tesla (T) is a standard for MRI, but high-field systems have magnetic fields of 3 T or 7 T. Precisely, the Hospital Ruber International has been the first European center to have 3 T full body for clinical use.
Juan Álvarez-Linera Prado, chief neuroradiologist of the Diagnostic Imaging Service at Hospital Ruber Internacional
«With high-field magnetic resonance we obtain images of high resolution and greater contrast,” says the neuroradiologist, who adds that, in addition, they use different protocols or sequences in which they can modify some of the machine’s parameters and even “fuse data that comes from different sequences to obtain images that allow us see injuries or structural details that were not originally visible.”
In this sense, high-field magnetic resonance allows visualizein greater detail than conventional techniques, structures related to Parkinson’s disease, such as the substantia nigra, nigrosomes – areas of the substantia nigra, specifically the zona compacta, where dopaminergic cells are very abundant – and neuromelanin – a pigment which is found in the neurons of the central nervous system, especially in areas such as the substantia nigra.
The future in the diagnosis of Parkinson’s
Generally, says Dr. Álvarez-Linera, the diagnosis of Parkinson’s disease is clinical, that is, it is made through a detailed evaluation of the patient’s medical history and a complete neurological examination, which is performed by a neurologist who is an expert in movement disorders. In that sense, magnetic resonance imaging or tomography by positon emission, both brain imaging tests, “are essential to identify possible changes in the brain and rule out other diseases that mimic Parkinson’s.”
The doctor emphasizes that the future of Parkinson’s diagnosis is not only in the use of 7 Tesla magnetic fields, but also “in the Artificial intelligence (AI), thanks to which the protocols in the 3 T fields will be improved to be able to extract information in a more reliable and effective way.
Along these lines, the head of the Diagnostic Imaging Service at Hospital Ruber Internacional affirms that, in a few years, any patient who begins to have symptoms Parkinson’s suspects will be able to undergo a high-field MRI as screening, thus achieving an early diagnosis of the disease.
