Objective of the Review: To describe available methods of structural neuroimaging in Parkinson’s disease (PD). Key Points. PD is the second neurodegenerative disease in terms of prevalence; it is a significant medical, social and economic issue. Early diagnosis is the most promising method for the implementation of neuroprotective strategies and preventive therapy in PD. However, differential diagnosis of parkinsonian syndromes is one of the most complicated in neurology. The article describes use of methods of structural neuroimaging in PD diagnostics, in particular of MRI images weighed by magnetic susceptibility, MRI with Т1-weighed images, transcranial sonography. It is demonstrated that these methods can be efficient in patients at an early full-fledged PD stage, where differential diagnosis has to be made or confirmed. Conclusion. Modern methods of structural neuroimaging help not only prevent the causes of secondary parkinsonism, but also confirm PD, also at an early stage of the disease. Keywords: Parkinson’s disease, neuroimaging magnetic-resonance imaging, positron emission tomography, SPECT-imaging, transcranial sonography.

Objective of the Review: To describe available functional neuroimaging techniques for use in patients with Parkinson’s disease (PD). Key Points: Parkinson’s disease is a neurodegenerative disorder which affects 2-3% of people older than 65 years. The main neuropathological hallmarks of PD are an accumulation of alpha-synuclein aggregates in the cellular cytoplasm and a loss of neurons in the pars compacta of the substantia nigra, leading to dopamine deficiency. Clinical symptoms of the disease appear when the underlying neural impairment is already advanced, which significantly reduces treatment options. Over the two last decades, functional neuroimaging techniques such as positron emission tomography, single-photon emission computed tomography, proton magnetic resonance spectroscopy, and transcranial sonography have increasingly been used for diagnosing PD during patients’ lifetime and understanding the neuropathological mechanisms and compensatory reactions underlying its symptoms, as well as for monitoring the progression of PD. Conclusion: Modern functional neuroimaging techniques not only facilitate differential diagnosis of PD, but also make it possible to detect the disease at its early/preclinical stage. Keywords: Parkinson’s disease, neuroimaging, positron emission tomography, single-photon emission computed tomography, proton magnetic resonance spectroscopy, transcranial sonography.

The temporal lobe is the most epileptogenic region of the brain. 90% of patients with temporal ictal epileptomorphic EEG activity have a variable long history of seizures. Magnetic resonance spectroscopy (MRS) may be useful in identifying an epileptogenic focus in patients with epilepsy without apparent structural pathology at neuroimaging.Objective: to systematize the results of early studies on this issue.Materials and methods.An electronic search was carried out in two English-language (Medline, PubMed) and one Russian-language (eLIBRARY.RU) databases. The search queries found 18,019 citations, by which 12 full-text articles were selected.Results and discussion.The main criteria for the diagnosis of temporal lobe epilepsy by MRS is to lower the level of N-acetylaspartate (NAA), the ratio of NAA to creatinine + choline (NAA/(Cr + Cho) in the brain region where there is neuronal death or damage, as well as a change in the level of myo-inositol, the elevated level of which indicates the presence of an epileptogenic focus, while the decreased one shows the spread of pathological activity to the adjacent tissues.Conclusion.This review will contribute to a better diagnosis of temporal lobe epilepsy, as well as to the intravital noninvasive detection of metabolic changes in the brain long before the development of structural pathology.

Subcortical laminar heterotopia (double cortex syndrome) is an orphan disease with an incidence of 1 to 200,000 people in the population. The cause of the disease is mutation of the gene DCX (synonyms: DBCN, XLIS) in chromosome Xq22.3-q23. The type of inheritance is X-linked dominant. Correct diagnosis requires a high degree of skills of a neurologist/epileptologist and a radiologist. The paper describes a clinical case of the late diagnosis of double cortex syndrome in a 36-year-old woman with a long history of resistant atonic seizures and mental retardation.