title: Clinical Application of Brain MRI in the Diagnostic Work-up of Parkinsonism.
abstract: Differentiating Parkinson's disease and atypical parkinsonism on clinical parameters is challenging, especially in early disease courses. This is due to large overlap in symptoms and because the so called red flags, i.e. symptoms indicating atypical parkinsonism, have not (fully) developed. Brain MRI can aid to improve the accuracy and confidence about the diagnosis.
  
  
  
  In the current paper, we discuss when brain MRI should be performed in the diagnostic work-up of parkinsonism, our preferred brain MRI scanning protocol, and the diagnostic value of specific abnormalities.
  
  
  
  The main purpose of brain MRI is to assess cerebrovascular damage, and to exclude other possible - and sometimes treatable - causes of parkinsonism, such as normal pressure hydrocephalus. Furthermore, brain MRI can support the possible or probable diagnosis of a specific form of atypical parkinsonism.
authors.affiliation: Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Frederick J A
authors.initials: FJA
authors.lastname: Meijer
authors.affiliation: Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.|Department of Diagnostic Imaging, Medical Center of Postgraduate Education, Warsaw, Poland.
authors.forename: Bozena
authors.initials: B
authors.lastname: Goraj
authors.affiliation: Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Bastiaan R
authors.initials: BR
authors.lastname: Bloem
authors.affiliation: Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Rianne A J
authors.initials: RAJ
authors.lastname: Esselink
mesh_terms: D001921:Brain / Q000000981:diagnostic imaging* / Q000473:pathology*; D003937:Diagnosis, Differential; D006801:Humans; D008279:Magnetic Resonance Imaging; D020734:Parkinsonian Disorders / Q000000981:diagnostic imaging* / Q000473:pathology*; D012680:Sensitivity and Specificity
keywords: Atypical parkinsonism; Parkinson’s disease; brain; magnetic resonance imaging