Beyond Parkinson's Disease: A Narrative Review of Neuromelanin MRI in Neurodegenerative Diseases

IF 2.5 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Neuroimaging Pub Date : 2025-11-30 DOI:10.1111/jon.70113

Anushree Burade, Dhairya A. Lakhani, Richard Dagher, John Anosh, Haris I. Sair, Licia P. Luna

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引用次数: 0

Abstract

Background and Purpose

Neuromelanin-sensitive magnetic resonance imaging (NM-MRI) is an emerging noninvasive biomarker of catecholaminergic neurons. It assesses neuromelanin-rich regions such as the substantia nigra pars compacta (SNc) and locus coeruleus (LC). Although initially developed for Parkinson's disease (PD), evidence supports broader utility. This narrative review highlights the diagnostic and prognostic applications of NM-MRI in PD, atypical parkinsonian syndromes, spinocerebellar ataxias (SCA), and Alzheimer's disease (AD), while evaluating methodological heterogeneity, diagnostic performance across diseases, and directions for clinical implementation.

Results

In PD, reduced SNc volume and contrast-to-noise ratio (CNR) correlate with motor symptom severity. Early-stage PD shows lateral SNc signal attenuation progressing ventromedially with disease advancement. NM-MRI sensitivity and specificity range from 70%–92% to 65%–89%, respectively, with higher accuracy at 7T. In progressive supranuclear palsy (PSP), SNc degeneration is more pronounced medially; LC contrast ratio (CR) is elevated compared to PD. In multiple system atrophy (MSA), LC signal attenuation is particularly marked in the parkinsonian subtype (MSA-P). NM-MRI findings in SCA (notably SCA2 and SCA7) vary by genotype; AD is characterized by reduction in the middle and caudal segments of LC, reflecting early tau pathology. NM-MRI LC signal reduction variably correlates with cognitive scores and Braak staging, suggesting potential as a preclinical biomarker.

Conclusion

NM-MRI holds promise for early diagnosis and monitoring of neurodegenerative diseases. While its role in PD is well established, emerging data in PSP, MSA, SCA, and AD suggest wider applicability. Standardization, multimodal imaging integration, and machine learning are critical for clinical translation.

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超越帕金森病：神经退行性疾病中神经黑色素MRI的叙述性回顾。

背景与目的：神经黑色素敏感磁共振成像（NM-MRI）是一种新兴的儿茶酚胺能神经元的无创生物标志物。它评估了富含神经黑色素的区域，如黑质致密部（SNc）和蓝斑（LC）。虽然最初是为帕金森病（PD）开发的，但证据支持更广泛的应用。本文综述了纳米磁共振成像在帕金森病、非典型帕金森综合征、脊髓小脑共济失调（SCA）和阿尔茨海默病（AD）中的诊断和预后应用，同时评估了方法的异质性、不同疾病的诊断性能和临床应用方向。结果：在PD中，SNc体积和噪声对比比（CNR）的减少与运动症状的严重程度相关。早期PD表现为SNc信号随疾病进展向腹内方向减弱。NM-MRI的敏感性和特异性分别为70%-92%和65%-89%，在7T时准确率更高。在进行性核上性麻痹（PSP）中，SNc变性在内侧更为明显；LC对比比（CR）较PD升高。在多系统萎缩（MSA）中，LC信号衰减在帕金森亚型（MSA- p）中尤为明显。SCA（尤其是SCA2和SCA7）的NM-MRI表现因基因型而异；AD的特点是LC的中部和尾端节段减少，反映了早期tau病理。纳米核磁共振LC信号减少与认知评分和Braak分期有不同的相关性，提示有可能作为临床前生物标志物。结论：纳米核磁共振成像对神经退行性疾病的早期诊断和监测具有重要意义。虽然其在PD中的作用已经确立，但在PSP、MSA、SCA和AD中的新数据表明其具有更广泛的适用性。标准化、多模态成像集成和机器学习对临床翻译至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Neuroimaging 医学-核医学

CiteScore

4.70

自引率

0.00%

发文量

117

审稿时长

6-12 weeks

期刊介绍： Start reading the Journal of Neuroimaging to learn the latest neurological imaging techniques. The peer-reviewed research is written in a practical clinical context, giving you the information you need on: MRI CT Carotid Ultrasound and TCD SPECT PET Endovascular Surgical Neuroradiology Functional MRI Xenon CT and other new and upcoming neuroscientific modalities.The Journal of Neuroimaging addresses the full spectrum of human nervous system disease, including stroke, neoplasia, degenerating and demyelinating disease, epilepsy, tumors, lesions, infectious disease, cerebral vascular arterial diseases, toxic-metabolic disease, psychoses, dementias, heredo-familial disease, and trauma.Offering original research, review articles, case reports, neuroimaging CPCs, and evaluations of instruments and technology relevant to the nervous system, the Journal of Neuroimaging focuses on useful clinical developments and applications, tested techniques and interpretations, patient care, diagnostics, and therapeutics. Start reading today!