Chapter 1 - Parkinson's disease and related disorders: the pursuit for reliable readouts and the role of neuroimaging

Abstract

Movement disorders represent a large, heterogenous group of disabling neurological conditions that recognize a variety of neurodegenerative or nondegenerative causes. They are generally divided clinically into hypokinetic movement disorders such as Parkinsonism and atypical Parkinsonism, and hyperkinetic movement disorders such as Huntington's disease and essential tremor. The etiology and progression of these disorders remain unclear, and there is a need for disease-modifying therapies. Neuroimaging techniques, including magnetic resonance imaging, positron emission tomography, and single photon computed tomography, make it possible to investigate structural, functional, and biological processes in vivo. Striving toward personalized medicine approaches, neuroimaging offers tools to aid the identification of individual disease signatures and projected clinical outcomes for targeting therapeutic intervention. Neuroimaging has multiple potential applications for clinical trials from improving study design and pathology-based phenotypic stratification and offering robust outcome measures including efficacy and safety. This chapter introduces clinical aspects of Parkinson's disease and related movement disorders, which are discussed in chapters throughout this book, and highlights the application of neuroimaging for robust measures in clinical trials.