Can Neuroimaging Predict Dementia in Parkinson's Disease?

Juliette H. Lanskey; Peter McColgan; Anette E. Schrag; Julio Acosta-Cabronero; Geraint Rees; Huw R. Morris; Rimona S. Weil


Brain. 2018;141(9):2545-2560. 

In This Article


In its current state, neuroimaging is still not able to accurately predict dementia in patients affected by Parkinson's disease. However, new techniques sensitive to tissue microstructure/biochemical alterations that reflect the very earliest stages of cognitive involvement are now becoming available. The most predictive technologies are likely to be sensitive to axonal damage, show specificity for underlying neuropathological substrates, such as ligands that bind to tau and amyloid, and may involve multimodal approaches. They will need to be specifically tested longitudinally in large-scale studies of patients with Parkinson's disease to assess their role in early detection of cognitive involvement and ultimately in predicting Parkinson's dementia. The current move towards large-scale, international collaborative imaging initiatives, especially in combination with other clinical and biological modalities is an essential step towards better-powered, longitudinal imaging studies to provide insights into the biology underlying dementia in Parkinson's disease and ultimately pave the way for therapeutic interventions aimed at slowing the development of dementia in Parkinson's disease.