title: [Functional neuroimaging in the diagnosis of patients with Parkinsonism: Update and recommendations for clinical use].
abstract: Functional Neuroimaging has been traditionally used in research for patients with different Parkinsonian syndromes. However, the emergence of commercial radiotracers together with the availability of single photon emission computed tomography (SPECT) and, more recently, positron emission tomography (PET) have made them available for clinical practice. Particularly, the development of clinical evidence achieved by functional neuroimaging techniques over the past two decades have motivated a progressive inclusion of several biomarkers in the clinical diagnostic criteria for neurodegenerative diseases that occur with Parkinsonism. However, the wide range of radiotracers designed to assess the involvement of different pathways in the neurodegenerative process underlying Parkinsonian syndromes (dopaminergic nigrostriatal pathway integrity, basal ganglia and cortical neuronal activity, myocardial sympathetic innervation), and the different neuroimaging techniques currently available (scintigraphy, SPECT and PET), have generated some controversy concerning the best neuroimaging test that should be indicated for the differential diagnosis of Parkinsonism. In this article, a panel of nuclear medicine and neurology experts has evaluated the functional neuroimaging techniques emphazising practical considerations related to the diagnosis of patients with uncertain origin parkinsonism and the assessment Parkinson's disease progression.
authors.affiliation: Grupo de Trabajo de Neuroimagen de la SEMNIM, Servicio de Medicina Nuclear, Clínica Universidad de Navarra, Pamplona, España. Electronic address: jarbizu@unav.es.
authors.forename: J
authors.initials: J
authors.lastname: Arbizu
authors.affiliation: Grupo de Trastornos del Movimiento de la SEN, Departamento de Neurología, Clínica Universidad de Navarra, Pamplona, España.
authors.forename: M R
authors.initials: MR
authors.lastname: Luquin
authors.affiliation: Servicio de Neurología, Hospital A, Marcide, Ferrol, España.
authors.forename: J
authors.initials: J
authors.lastname: Abella
authors.affiliation: Servicio de Neurología, Hospital A, Marcide, Ferrol, España.
authors.forename: R
authors.initials: R
authors.lastname: de la Fuente-Fernández
authors.affiliation: Servicio de Neurología, Hospital Universitario Donostia, Área de Neurociencias, Instituto de Investigación Biodonostia, CIBERNED, San Sebastián, España.
authors.forename: R
authors.initials: R
authors.lastname: Fernandez-Torrón
authors.affiliation: Servicio de Medicina Nuclear, UDIM, Hospital Universitario Virgen del Rocío, Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Sevilla, España.
authors.forename: D
authors.initials: D
authors.lastname: García-Solís
authors.affiliation: Servicio de Medicina Nuclear, Hospital San Pedro, CIBIR, Logroño, España.
authors.forename: P
authors.initials: P
authors.lastname: Garrastachu
authors.affiliation: Servicio de Medicina Nuclear, Hospital Universitario Virgen de la Victoria, Málaga, España.
authors.forename: J M
authors.initials: JM
authors.lastname: Jiménez-Hoyuela
authors.affiliation: Servicio de Neurología, Hospital A, Marcide, Ferrol, España.
authors.forename: M
authors.initials: M
authors.lastname: Llaneza
authors.affiliation: Servicio de Medicina Nuclear, Hospital Clinic, Barcelona, España.
authors.forename: F
authors.initials: F
authors.lastname: Lomeña
authors.affiliation: Servicio de Medicina Nuclear, Hospital Vall d́Hebron, CETIR-ERESA, Unitat Teknon, Barcelona, España.
authors.forename: C
authors.initials: C
authors.lastname: Lorenzo-Bosquet
authors.affiliation: Unidad de Parkinson y Trastornos del Movimiento, Servicio de Neurología, ICN, CIBERNET, Hospital Clinic, Barcelona, España.
authors.forename: M J
authors.initials: MJ
authors.lastname: Martí
authors.affiliation: Servicio de Neurología, Hospital Ramón y Cajal, Madrid, España.
authors.forename: J C
authors.initials: JC
authors.lastname: Martinez-Castrillo
authors.affiliation: Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío, Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Sevilla, España.
authors.forename: P
authors.initials: P
authors.lastname: Mir
authors.affiliation: Servicio de Medicina Nuclear, Hospital Universitario Puerta de Hierro, Madrid, España.
authors.forename: M
authors.initials: M
authors.lastname: Mitjavila
authors.affiliation: Unidad de Parkinson y otros Trastornos del Movimiento, Servicio de Neurología, Hospital Universitario Donostia, CIBERNED, Instituto de Salud Carlos III, San Sebastián (Guipúzcoa), España.
authors.forename: J
authors.initials: J
authors.lastname: Ruiz-Martínez
authors.affiliation: Servicio de Neurología, Hospital Universitario Fundación Alcorcón, Alcorcón, España.
authors.forename: L
authors.initials: L
authors.lastname: Vela
mesh_terms: D000465:Algorithms; D003937:Diagnosis, Differential; D059907:Functional Neuroimaging; D006801:Humans; D020734:Parkinsonian Disorders / Q000000981:diagnostic imaging*; D049268:Positron-Emission Tomography; D017410:Practice Guidelines as Topic; D015899:Tomography, Emission-Computed, Single-Photon
keywords: Diagnóstico diferencial; Differential diagnosis; Enfermedad de Parkinson; Gammagrafía; PET; Parkinson disease; Parkinsonism; Parkinsonismo; SPECT; Scintigraphy