Neuroimaging Clinics RSS feed: Current Issue. Neuroimaging Clinics of North America updates you on the latest trends in patient management; keeps you up to date on the newest advances; and provides a sound basis for choosing treatment options. Each issue focuses on a single topic in neuroimaging and is presented under the direction of an experienced guest editor. In addition, you can earn valuable CME credits - up to 60 per year - with your subscription.http://www.neuroimaging.theclinics.com/?rss=yesElsevier Inc.de © 2010 Elsevier Inc. All rights reserved. Neuroimaging Clinics1052-5149201February 2010 © 2010 Elsevier Inc. All rights reserved. healthpermissions@elsevier.comhttp://www.neuroimaging.theclinics.com/article/PIIS1052514909001282/abstract?rss=yesCME Accreditation Page and Author Disclosure10.1016/j.nic.2009.11.003Neuroimaging Clinics 20, 1 (2010)2010-02-01Neuroimaging Clinics2010-02-01201S1052-5149(09)X0005-5iiiiiihttp://www.neuroimaging.theclinics.com/article/PIIS105251490900121X/abstract?rss=yesForthcoming/Recent Issues10.1016/S1052-5149(09)00121-XNeuroimaging Clinics 20, 1 (2010)2010-02-01Neuroimaging Clinics2010-02-01201S1052-5149(09)X0005-5ivivhttp://www.neuroimaging.theclinics.com/article/PIIS1052514909001233/abstract?rss=yesContents10.1016/S1052-5149(09)00123-3Neuroimaging Clinics 20, 1 (2010)2010-02-01Neuroimaging Clinics2010-02-01201S1052-5149(09)X0005-5viiixhttp://www.neuroimaging.theclinics.com/article/PIIS1052514909000896/abstract?rss=yesTo Indra, for her continuous support; to Lina and Norine, for the joy they give me every day; to my brother, for his companionship; to my mother, for her dedication and everlasting affection; and, of course, to you, my father. All you were to me is in this one word: Father. You prepared me for everything in life, but nothing could have prepared me for this. To your memory.DedicationTarek A. Yousry10.1016/j.nic.2009.10.003Neuroimaging Clinics 20, 1 (2010)2010-02-01Neuroimaging Clinics2010-02-01201S1052-5149(09)X0005-5xixihttp://www.neuroimaging.theclinics.com/article/PIIS1052514909000902/abstract?rss=yesFor some time, the main role of neuroimaging in the field of movement disorders was to exclude uncommon but potentially reversible structural abnormalities. However, the advent of magnetic resonance imaging and related techniques, such as diffusion tensor imaging, as well as nuclear medicine techniques, such as positron emission tomography (PET) and dopamine transporter single photon emission computed tomography (SPECT) imaging (DaT-scan), opened up new opportunities to diagnose movement disorders on the basis of objective findings. Nevertheless, the practical value of various neuroimaging techniques in clinical routine is not well known and their potential future development is not well appreciated. With this in mind, we approached leaders in the field who can both assess the relevance of various imaging tools and present their insight into the latest advances from a research perspective. This issue therefore starts by providing an overview of the clinical classification of movement disorders, and then describes the imaging anatomy of some of the structures involved in such disorders. This is followed by an assessment of magnetic resonance and nuclear medicine techniques in various movement disorders. We dedicated an article to the role of transcranial ultrasound, a technique that is gaining a lot of interest and could be of important practical relevance soon. A case-based approach provides real-life scenarios to demonstrate the contribution of neuroimaging techniques to the diagnosis and management of movement disorders. The issue concludes by addressing the important role of imaging in the surgical treatment of these disorders.PrefaceTarek A. Yousry, Andrew J. Lees10.1016/j.nic.2009.10.004Neuroimaging Clinics 20, 1 (2010)2010-02-01Neuroimaging Clinics2010-02-01201S1052-5149(09)X0005-5xiiixiiihttp://www.neuroimaging.theclinics.com/article/PIIS105251490900080X/abstract?rss=yesClassification of diseases aids understanding and activity by creating an overview. No single classification can serve all purposes, and it is helpful to be aware of the range of methods available and to understand what they set out to achieve. This article focuses on factors that help the interaction between clinicians and radiologists, with the aim of clarifying how these schemes are generated.Classification of Movement DisordersA.P. Moore10.1016/j.nic.2009.08.018Neuroimaging Clinics 20, 1 (2010)2010-02-01Neuroimaging Clinics2010-02-01201S1052-5149(09)X0005-516http://www.neuroimaging.theclinics.com/article/PIIS1052514909000872/abstract?rss=yesThe substantia nigra and subthalamic nucleus are two key structures in the midbrain that are very important in movement disorders, particularly those associated with parkinsonism. Using conventional magnetic resonance (MR) imaging, the anatomic description of both these structures can be challenging. This article describes the importance of understanding the underlying anatomy and some of the changes associated with pathology in these structures. Advances in MR imaging are discussed, including high-field MR imaging, diffusion tensor imaging, inversion-recovery imaging, and susceptibility-weighted imaging, with particular reference to the substantia nigra and subthalamic nucleus. Understanding of MR imaging features of these nuclei needs to be firmly based on underlying knowledge of anatomy and pathology from postmortem studies, and more work is needed in this field.Anatomy of the Substantia Nigra and Subthalamic Nucleus on MR ImagingL.A. Massey, T.A. Yousry10.1016/j.nic.2009.10.001Neuroimaging Clinics 20, 1 (2010)2010-02-01Neuroimaging Clinics2010-02-01201S1052-5149(09)X0005-5727http://www.neuroimaging.theclinics.com/article/PIIS1052514909000781/abstract?rss=yesParkinson disease (PD) is the most common neurodegenerative cause of parkinsonism, followed by progressive supranuclear palsy and multiple system atrophy (MSA). Despite published consensus operational criteria for the diagnosis of PD and the various atypical parkinsonian disorders (APD) such as progressive supranuclear palsy, Parkinson variant of MSA, and corticobasal degeneration, differentiation of these clinical entities may be challenging, particularly in the early stages of the disease. Diagnosis of PD and its distinction from APD and symptomatic parkinsonism is crucial for the clinical evaluation, as these disorders differ in prognosis, treatment response, and molecular pathogenesis. Despite limitations the different modern magnetic resonance (MR) techniques have undoubtedly added to the differential diagnosis of neurodegenerative parkinsonism. This article focuses on static or structural conventional MR imaging techniques including standard T2-weighted, T1-weighted, and proton-density sequences, as well as different advanced techniques, including methods to assess regional cerebral atrophy quantitatively such as magnetic resonance volumetry, diffusion tensor and diffusion-weighted imaging, and magnetization transfer imaging, to assist in the differential diagnosis of neurodegenerative parkinsonian disorders.Brain Magnetic Resonance Imaging Techniques in the Diagnosis of Parkinsonian SyndromesKlaus Seppi, Werner Poewe10.1016/j.nic.2009.08.016Neuroimaging Clinics 20, 1 (2010)2010-02-01Neuroimaging Clinics2010-02-01201S1052-5149(09)X0005-52955http://www.neuroimaging.theclinics.com/article/PIIS1052514909000793/abstract?rss=yesExtrapyramidal syndromes (ES) belong to the most common neurologic illnesses. Because new and promising therapeutic options are currently under development, there is a substantial demand for molecular imaging procedures with the potential to identify the pathologic changes of those illnesses. This article gives an overview of the current positron emission tomography and single photon emission computed tomography applications for diagnosing ES and focuses on their use in clinical practice.Extrapyramidal Syndromes: PET and SPECTKlaus Tatsch10.1016/j.nic.2009.08.017Neuroimaging Clinics 20, 1 (2010)2010-02-01Neuroimaging Clinics2010-02-01201S1052-5149(09)X0005-55768http://www.neuroimaging.theclinics.com/article/PIIS1052514909000689/abstract?rss=yesParkinsonism is a syndrome that features bradykinesia (slowness of the initiation of voluntary movement) and at least 1 of the following conditions: rest tremor, muscular rigidity, or postural instability. Criteria for the clinical diagnosis of vascular parkinsonism (VP) have been proposed, which are derived from a postmortem examination study. Computed tomography and magnetic resonance imaging can support this clinical diagnosis with positive imaging findings. Dopamine transporter single-photon emission computed tomography may also be of help to distinguish VP from Parkinson disease and other parkinsonisms.The Role of Imaging in the Diagnosis of Vascular ParkinsonismJan C.M. Zijlmans10.1016/j.nic.2009.08.006Neuroimaging Clinics 20, 1 (2010)2010-02-01Neuroimaging Clinics2010-02-01201S1052-5149(09)X0005-56976http://www.neuroimaging.theclinics.com/article/PIIS1052514909000628/abstract?rss=yesThe role for neuroimaging in the management of patients with tremor is gradually increasing, particularly with respect to stereotactic neurosurgery and deep brain stimulation where less than 2-mm tolerance is required for accurate electrode placement. The routine use of single photon emission CT technology to image the nigrostriatal dopaminergic system is proving helpful in distinguishing essential and dystonic tremors from neurodegenerative forms of parkinsonism and in improving our understanding of the pathophysiology of rarer tremors.Role of Neuroimaging in the Evaluation of TremorDavina J. Hensman, Peter G. Bain10.1016/j.nic.2009.08.005Neuroimaging Clinics 20, 1 (2010)2010-02-01Neuroimaging Clinics2010-02-01201S1052-5149(09)X0005-57786http://www.neuroimaging.theclinics.com/article/PIIS1052514909000641/abstract?rss=yesTranscranial B-mode sonography (TCS) may provide supplementary information to other neuroimaging methods, adding valuable information to the diagnosis and differential diagnosis of movement disorders. The value of TCS in the differential and early diagnosis of Parkinson disease (PD) has been proven. There is increasing evidence that substantia nigra hyperechogenicity, the ultrasound marker typical for PD, may disclose a nigrostriatal vulnerability if found in healthy people, which may contribute to defining high-risk groups for this neurodegenerative disorder. This article provides information about the ultrasound procedure, its specific diagnostic value, and its limitations. Pathophysiologic mechanisms leading to changes in the reflection of ultrasound waves are discussed.Role of Transcranial Ultrasound in the Diagnosis of Movement DisordersJana Godau, Daniela Berg10.1016/j.nic.2009.08.003Neuroimaging Clinics 20, 1 (2010)2010-02-01Neuroimaging Clinics2010-02-01201S1052-5149(09)X0005-587101http://www.neuroimaging.theclinics.com/article/PIIS1052514909000665/abstract?rss=yesThe functional magnetic resonance (fMR) technique for brain mapping is a valuable tool for understanding both normal physiology and the dysfunction taking place in disorders of the brain. This article provides an overview of fMR imaging methods and their applications in the study of neurologic movement disorders. The article also reviews the current neuroimaging literature regarding parkinsonisms, dystonia, essential tremor, and Huntington disease, and includes a discussion of current methodological limitations and future directions for this exciting field.Current Role of Functional MRI in the Diagnosis of Movement DisordersFatta B. Nahab, Mark Hallett10.1016/j.nic.2009.08.001Neuroimaging Clinics 20, 1 (2010)2010-02-01Neuroimaging Clinics2010-02-01201S1052-5149(09)X0005-5103110http://www.neuroimaging.theclinics.com/article/PIIS105251490900063X/abstract?rss=yesThe main role of computed axial tomography in the field of movement disorders was to exclude uncommon but potentially reversible structural abnormalities including tumors, chronic subdural hematoma, and communicating hydrocephalus presenting with parkinsonism. In the past 20 years magnetic resonance has had greater impact in facilitating accurate diagnosis but its clinical usefulness is less than in some other neurologic fields. Dopamine transporter SPECT imaging is helpful in distinguishing benign tremulous Parkinson disease from atypical tremor syndromes and other clinical scenarios where the demonstration of nigrostriatal dopamine denervation is helpful. We use eight case vignettes to illustrate how MR imaging findings can assist in the diagnosis of movement disorders and, in some cases, change the course of patient management.How Can Neuroimaging Help in the Diagnosis of Movement Disorders?Helen Ling, Andrew J. Lees10.1016/j.nic.2009.08.004Neuroimaging Clinics 20, 1 (2010)2010-02-01Neuroimaging Clinics2010-02-01201S1052-5149(09)X0005-5111123http://www.neuroimaging.theclinics.com/article/PIIS1052514909000653/abstract?rss=yesFunctional neurosurgery involves precise surgical targeting of anatomic structures to modulate neurologic function. From its conception, advances in the surgical treatment of movement disorders have been intertwined with developments in medical imaging, culminating in the use of stereotactic magnetic resonance imaging (MRI). Meticulous attention to detail during image acquisition, direct anatomic localization, and planning of the initial surgical trajectory allows the surgeon to reach the desired anatomic and functional target with the initial trajectory in most cases, thus reducing the need for multiple passes through the brain, and the associated risk of hemorrhage and functional deficit. This philosophy is of paramount importance in a procedure that is primarily aimed at improving quality of life. Documentation of electrode contact location by means of stereotactic imaging is essential to audit surgical targeting accuracy and to further the knowledge of structure-to-function relationships within the human brain.The Role of Imaging in the Surgical Treatment of Movement DisordersLudvic Zrinzo10.1016/j.nic.2009.08.002Neuroimaging Clinics 20, 1 (2010)2010-02-01Neuroimaging Clinics2010-02-01201S1052-5149(09)X0005-5125140http://www.neuroimaging.theclinics.com/article/PIIS1052514909001245/abstract?rss=yesIndex10.1016/S1052-5149(09)00124-5Neuroimaging Clinics 20, 1 (2010)2010-02-01Neuroimaging Clinics2010-02-01201S1052-5149(09)X0005-5141144