Parkinson's disease (PD) is the second most common neurodegenerative disease after Alzheimer's disease and the first one among the nosological entities of parkinsonism. Susceptibility-weighted imaging (SWI), magnetic resonance imaging (MRI) pulse sequence, which allows the in vivo estimation of the values of iron deposition in different areas of the brain, is a potential technique for the early diagnosis of PD and for the study of the pathogenesis of its complications.Objective: to compare the values of iron deposition in the basal ganglia in Stages II and III PD and to determine the relationship of clinical findings to the level of iron deposition according to the SWI findings.Patients and methods. Twenty-four patients with Hoehn and Yahr Stages II (n=24) and III (n=12) PD were examined. All the patients underwent brain MRI on a Siemens TrioTim (3T) MRI scanner by using pulse sequences T1, T2, SWI and subsequently quantifying the iron deposition (SPIN software). The accumulation of iron is visualized as an area of reduced signal intensity on SWI, and its estimation in accordance with the SPIN program has accordingly a smaller value. The regions of interest on both sides were the dentate nucleus, substantia nigra, red nucleus, putamen, globus pallidus, and head of the caudate nucleus. The examination protocol also included tests using the following scales: the Unified Parkinson's Disease Rating Scale (UPDRS), the Mini-Mental State Examination (MMSE), Frontal Assessment Batter (FAB), Freezing of Gait (FOG), Gait and Balance Scale (GABS), the Epworth Daytime Sleepiness Scale, the Parkinson's Disease Quality of Life Questionnaire (PDQ), the Beck Depression Inventory, and the Clock-Drawing Test.Results and discussion. The investigators found significant (p<0.05) correlations between the clinical picture and the level of iron deposition in the regions of interest in patients with Stage II PD: FOG – left caudate nucleus (r=-0.94); GABS – left caudate nucleus (r=-0.94); and in patients with stage III of the disease: UPDRS (full) – left red nucleus (r=-0.82), right globus pallidus (r=-0,80), left putamen (r=-0,96); UPDRS (Section 2) – left red nucleus (r=-0.77), left globus pallidus (r=-0.84); UPDRS (Section 3) – right putamen (r=-0,85), right globus pallidus (r=-0.78), left globus pallidus (r=-0,92); FOG – left globus pallidus (r=-0.81); GABS – left red nucleus (r=-0.96), left putamen (r=0.82), right putamen (r=-0.89), left globus pallidus (r=-0.82), right globus pallidus (r=-0.85), left caudate nucleus (r=-0.82), right caudate nucleus (r=-0.89); Beck Depression Inventory – right substantia nigra (r=-0.82).Conclusion. SWI measurement of the values of iron deposition in the structures of the extrapyramidal system in PD provides an additional insight into the pathological processes occurring in them.

ель исследования. Рассмотреть возможности применения стандартных прото-колов магнитно-резонансной томографии, режима SWI, методик постпроцес-синговой обработки данных, включающих морфометрию, трактографию и фМРТ покоя в дифференциальной диагностике синдромов паркинсонизма. Материалы и методы. Проанализированы нейровизуализационные маркеры прогрессирования болезни Паркинсона и развития осложнений по данным МРТ. На ос-нове литературных данных и результатов собственных исследований показана высокая ценность применения новых протоколов нейровизуализации при синдромах паркинсо-низма и болезни Паркинсона.Выводы. Новые методики, как нативной, так и постпроцессинговой МРТ, позво-ляют осуществлять дифференциальную диагностику заболеваний, протекающих с син-дромом паркинсонизма, а также проводить динамическое наблюдение за пациентами с целью раннего выявления групп риска с развитием осложнений и для своевременной коррекции терапии.Ключевые слова: магнитно-резонансная томография, морфометрия, трактогра-фия, фМРТ покоя, нейросети покоя, синдромы паркинсонизма, болезнь Паркинсона. urpose. To assess the use of standard protocols for magnetic resonance imaging, SWI mode, data post-processing techniques, including morphometry, tractography and rest fMRI in differential diagnostics of parkinsonism syndromes. Materials and methods. Neuroimaging markers within the progression of Parkinson's disease and the development of complications from MRI data were analyzed. Based on the published data and own studies results, the high value of the application of the new neuroimaging protocols for Parkinson's syndromes and Parkinson's disease is presented.Conclusions. New methods, both native and post-processing MRI, allow differential diagnosis of diseases occurring with Parkinson's syndrome, as well as dynamic monitoring of patients with the purpose of early detection of risk groups patients with the development of complications and timely correction of therapy..

The aim of the study was to determine the localization of conductive pathways in patients with Parkinson's disease (PD) complicated with freezing of gait, by using data from magnetic resonance tractography, and to identify the prognostic value of these pathways in predicting the course of the disease.Materials and Methods. 78 patients with idiopathic PD were examined and divided into two groups: patients with freezing of gait (n=31) and without freezing of gait (n=47). The protocol of the investigation consisted of clinical evaluation of the condition of the patients to determine the stage of the disease, and the use of a Siemens MRI Device (magnetic induction field, 1.5 T) to obtain standard images of the coronary, axial and sagittal planes, as well as MRI-protocols of the T1 gradient echo, plus diffusion-tensor tractography with further analysis of the findings with FreeSurfer software.Results. The groups of patients showed statistically significant differences in the levels of the tract length, diffusivity and fractional anisotropy in the anterior thalamic radiations of both sides, the temporal area of the superior longitudinal fascicle on the left, the parietal area of the superior longitudinal fascicle on the right, and the corticospinal tract on the right. Analysis of the correlative tractographic values with the total scores on the walk-and-balance scale revealed that the highest prognostic value in the development of freezing of gait pertained to damage to the thalamo-frontal tract. A reduction in the value of the maximum voxel length to 80.0 or below, increased the risk of development of freezing of gait in 10 times.Conclusion. The results demonstrate the involvement of conduction pathways in the mechanisms leading to freezing of gait in PD. Early diagnosis and prediction of the development of this complication using magnetic resonance tractography can indicate the need to adjust the medical treatment and to develop an appropriate special system of rehabilitation.

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Magnetic stimulation is a noninvasive technique that allows you to directly stimulate the neurons of the cerebral cortex. Currently, transcranial magnetic stimulation is used as informative diagnostic and effective therapeutic techniques for the treatment of diseases and injuries of the nervous system. The article discusses the indications, contraindications and the recommended protocols for the use of transcranial magnetic stimulation in certain diseases and consequences of traumas of the nervous system (bibliography: 37 refs).