Advancements in ultrasonography and MRI for enhanced diagnosis of Parkinson's disease: An updated review

Parkinson's disease (PD) is a progressive neurological illness characterized by symptoms such as bradykinesia (slowness of movement), tremor, rigidity, and postural instability. Diagnosing parkinsonian syndromes (PS) can be challenging, even for specialized neurology centers, due to the high rate of diagnostic errors. This review article highlights the challenges in diagnosing PS and the importance of accurately differentiating it from PD. It discusses the utility of various magnetic resonance imaging (MRI) techniques and transcranial ultrasound (TUS) in improving diagnostic accuracy. The focus is on both conventional and cutting-edge MRI procedures, including T₂*/T₂-weighted MRI, susceptibility-weighted imaging (SWI), diffusion-weighted imaging (DWI), diffusion tensor imaging (DTI), magnetization transfer imaging (MTI), magnetic resonance spectroscopy (MRS), and ultra-high-resolution MRI. These advanced techniques have shown promising potential in aiding diagnosis and identifying early signs of PD. The review emphasizes the clinical relevance of these imaging modalities in discriminating PD from other parkinsonian disorders and detecting early-stage disease before the onset of clinical symptoms.