fMRI in Parkinson’s Disease

In this chapter we review recent advances in functional magnetic resonance imaging (fMRI) in Parkinson’s disease (PD). Covariance patterns of regional resting-state activity in functional brain networks can be used to distinguish Parkinson patients from healthy controls and might play an important role as a biomarker in the future. Analyses of motor activity and connectivity have revealed compensatory mechanisms for impaired function of cortico-subcortical feedback loops and have shown how attentional mechanisms modulate the activity in motor loops. Other fMRI studies probing cognitive functions and reward-related behavior have shown that dopamine replacement can have detrimental effects on non-motor brain functions by altering physiological patterns of dopaminergic signaling. Neuroimaging can also be used to assess preclinical compensation of striatal dopaminergic denervation by studying asymptomatic carriers of mutations in genes that can cause PD. In conclusion, fMRI is a powerful tool to monitor changes in functional neural networks and has given important new insights into the pathophysiology of PD.