Journal Article (Review Article)

DZNE-2026-00588

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Biologic Definition of Parkinson Disease: A Pivotal Role for Molecular Imaging.

Brendel, M. (First author)DZNE* ; Barthel, H. ; Höglinger, G. U. (Last author)DZNE*

2026
Soc. New York, NY

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Please use a persistent id in citations: doi:10.2967/jnumed.125.271573

Abstract: In this article, we outline the ongoing conceptual transition of Parkinson disease (PD) from a clinically defined syndrome to a biologically defined disorder. We synthesize recent advances in neuropathology, genetics, and biomarker research, with particular emphasis on the central role of molecular imaging within emerging biology-based frameworks. We discuss how established imaging biomarkers-including dopaminergic imaging, [18F]FDG PET, and cardiac [123I]MIBG scintigraphy-provide objective in vivo measures of neurodegeneration that complement α-synuclein seed amplification assays and genetic stratification. In addition, we review the current state of α-synuclein PET tracer development and critically evaluate its potential to enable direct visualization of disease-defining pathology in vivo. We highlight the growing importance of biomarker-driven classification systems for patient stratification and the design of trials of disease-modifying therapies in PD. At the same time, we address key scientific, methodologic, and ethical challenges associated with implementing biologically grounded disease definitions. Together, these developments position molecular imaging as a cornerstone of future precision medicine approaches in PD.

Keyword(s): Humans (MeSH) ; Parkinson Disease: diagnostic imaging (MeSH) ; Parkinson Disease: metabolism (MeSH) ; Parkinson Disease: pathology (MeSH) ; Molecular Imaging: methods (MeSH) ; Positron-Emission Tomography (MeSH) ; Biomarkers: metabolism (MeSH) ; PET ; Parkinson disease ; SPECT ; biologic definition ; neurology ; Biomarkers

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Contributing Institute(s):

1. Clinical Research (Munich) (Clinical Research (Munich))
2. Molecular Neurodegeneration (AG Haass)

Research Program(s):

1. 353 - Clinical and Health Care Research (POF4-353) (POF4-353)
2. 352 - Disease Mechanisms (POF4-352) (POF4-352)

Appears in the scientific report 2026

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Database coverage:
; BIOSIS Previews ; Biological Abstracts ; Clarivate Analytics Master Journal List ; Current Contents - Clinical Medicine ; Current Contents - Life Sciences ; Essential Science Indicators ; IF >= 5 ; JCR ; PubMed Central ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection

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