[Morphological magnetic resonance imaging: its value for the diagnosis of neurodegenerative diseases]. / Morphologische Magnetresonanz-Tomographie: Ihre Wertigkeit bei der Diagnose neurodegenerativer Erkrankungen.

Magnetic resonance imaging (MRI) plays an important role in differentiating idiopathic Parkinson's disease (PD) from its atypical forms. Causes like chronic vascular disease and normal-pressure hydrocephalus are easily visualized. Furthermore, specific atrophy patterns can be found with multi-system atrophies, corticobasal degeneration and progressive supranuclear palsy. In addition the review also deals with specific imaging criteria of other neurodegenerative disorders, such as Wilson's disease, neurodegeneration with iron accumulation in the brain and Huntington's chorea. MRI is of minor importance for differentiating Alzheimer's disease from frontotemporal dementia or dementia with Lewy bodies. However, specific patterns are found in cerebral amyloid angiopathy and prion diseases..

[Dementia with Lewy bodies and reduced dopamine transporter binding indicates significant acetylcholine deficiency]. / Demenz mit Lewy-Körperchen und verminderter Dopamin-Transporter-Bindung verweist auf Acetylcholin-Mangel.

Dementia with Lewy bodies (DLB) is the second most common form of neurodegenerative dementia. It is usually caused by a mixture of symptoms of Parkinson's and Alzheimer's disease leading to a significant impairment of nigro-striatal dopaminergic and baso-cortical cholinergic neurotransmission with typical clinical symptoms of a fluctuating course, hallucinations, parkinsonism, REM-sleep disorder and neuroleptic hypersensitivity. If the clinical presentation of DLB is uncharacteristic, the demonstration of reduced presynaptic striatal dopamine transporter (DaT) sites supports a suspicion of DLB and may lead to important therapeutic consequences. In these circumstances this evidence for compromised dopaminergic neurotransmission also indicates a significant cholinergic deficit: both require diligent therapeutic attention.

[Nuclear medicine imaging in neurodegenerative dementias]. / Nuklearmedizinische Bildgebung bei zerebralen Erkrankungen.

Single photon emission computed tomography (SPECT) and positron emission tomography (PET) are important tools in the differential diagnosis and therapeutic monitoring of cognitive disorders. SPECT and PET are highly sensitive methods for the early diagnosis of underlying neurodegeneration and the functional changes in the basal ganglia. Early and reliable diagnosis will become even more relevant with the development of options in the causal treatment of dementias, which would exert their most beneficial effects well before the onset of clinical symptoms. This review provides a brief survey on currently available methods of nuclear imaging in cortical (Alzheimer's disease) and subcortical forms of neurodegenerative dementia (Parkinson's disease; dementia with Lewy bodies).

[The status of imaging methods for the treatment of patients with Parkinson's syndrome]. / Stellenwert bildgebender Verfahren für die Therapie der Patienten mit Parkinsonsyndrom.

The accuracy of the diagnosis of Parkinson's disease early in the course of the disease remains a clinical challenge. Imaging of dopamine transporters with DatSCAN and SPEC tomography contributes to identifying patients without nigral degeneration and thus helps preventing unnecessary and potentially harmful treatments. The cost of these imaging procedures needs to be set against the cost of unnecessary medication.