Baptist Health Miami Neuroscience Institute Advances Parkinson's Disease Imaging With Specialized MRI Protocol

Diagnosing Parkinson’s disease has long depended primarily on clinical expertise—careful neurologic examination, longitudinal symptom assessment and the nuanced interpretation of movement abnormalities. But as imaging technology evolves, specialists at Baptist Health Miami Neuroscience Institute are helping advance a more precise and comprehensive diagnostic approach for Parkinson’s disease and related parkinsonian syndromes.

The Institute recently implemented an Advanced Parkinson MRI Protocol that incorporates dedicated high-resolution sequences on 3.0 Tesla MRI scanners to better visualize neurodegenerative changes involving the dopaminergic system. The protocol is designed to complement clinical evaluation and provide additional imaging biomarkers that may improve diagnostic confidence, particularly in complex or atypical cases.

“Parkinson’s disease remains fundamentally a clinical diagnosis, but advanced neuroimaging is becoming an increasingly important tool in helping us characterize these disorders more accurately,” said Diego Torres-Russotto, M.D., chair of neurology, Distinguished Endowed Chair in Neurology at Miami Neuroscience Institute, program director of the FIU/Baptist Health Neurology Residency Program, and professor at Florida International University Herbert Wertheim College of Medicine. “The ability to identify structural and biochemical changes earlier—and with greater specificity—can significantly enhance how we evaluate patients with suspected parkinsonian syndromes.”

Expanding the Role of MRI in Parkinsonian Disorders

The specialized MRI protocol incorporates advanced sequences focused on brain structures critically involved in motor control and neurodegeneration, including the substantia nigra and locus coeruleus.

Among the key imaging biomarkers evaluated are nigrosome-1 imaging and neuromelanin-sensitive MRI. Nigrosome-1 imaging uses susceptibility-weighted imaging to assess the integrity of dopaminergic neurons within the substantia nigra. Loss of the characteristic “swallow-tail” appearance has been associated with Parkinson’s disease. Neuromelanin-sensitive MRI allows visualization of neuromelanin-containing neurons in the substantia nigra and locus coeruleus, both known to degenerate in Parkinson’s disease and related disorders.

“Advanced MRI techniques are allowing us to visualize neurodegenerative changes that were previously very difficult to assess with conventional imaging,” said Leonardo Furtado Freitas, M.D., neuroradiologist with Baptist Health Brain & Spine Care and clinical associate professor at FIU Herbert Wertheim College of Medicine. “By incorporating these specialized sequences into our routine workflow, we are providing clinicians with additional imaging biomarkers that may support earlier and more accurate diagnosis of Parkinson’s disease and other parkinsonian syndromes.”

Dr. Freitas said the Advanced Parkinson MRI Protocol represents an important advancement because it combines structural and biochemical imaging data in a noninvasive study that can help neurologists better understand underlying neurodegenerative processes.

Supporting Earlier and More Precise Differential Diagnosis

One of the greatest diagnostic challenges in movement disorders is differentiating idiopathic Parkinson’s disease—meaning disease that has arisen from an unknown cause—from atypical parkinsonian syndromes such as progressive supranuclear palsy (PSP) and multiple system atrophy (MSA), conditions that may initially present with overlapping symptoms but differ significantly in prognosis and treatment strategies.

“These disorders can appear very similar early in their course, and that diagnostic uncertainty can have important implications for patients and families,” Dr. Torres-Russotto said. “Advanced MRI biomarkers provide another layer of information that can support the neurologic examination and help guide more informed clinical decision-making.”

The Advanced Parkinson MRI Protocol was developed through close collaboration between neuroradiology and movement disorder specialists at Miami Neuroscience Institute, reflecting the Institute’s multidisciplinary approach to complex neurologic disease.

According to Dr. Freitas, one of the goals was to create imaging pathways that integrate seamlessly into clinical workflows while also expanding access to advanced movement disorder imaging in South Florida.

“This is still an emerging area of neuroimaging, and not every center is offering these specialized MRI sequences,” Dr. Freitas said during a recent physician discussion about the initiative. “We saw an opportunity to build something innovative that could help both our referring physicians and our patients by expanding diagnostic capabilities here at Baptist Health.”

Complementing DaTSCAN and Functional Imaging

While dopamine transporter SPECT imaging, commonly known as DaTSCAN, remains an established tool for evaluating dopaminergic degeneration, Baptist Health Brain & Spine Care specialists emphasize that MRI-based biomarkers may serve as a complementary strategy in select patients.

Dr. Freitas noted that DaTSCAN studies are highly sensitive but not always specific, creating scenarios where advanced MRI findings may provide additional diagnostic context. In some cases, MRI may also offer an alternative when nuclear medicine imaging is unavailable or cannot be performed.

“The future of movement disorders imaging is not about replacing clinical expertise or replacing existing diagnostic tools,” Dr. Torres-Russotto said. “It is about integrating multiple complementary biomarkers that allow us to better phenotype disease, improve diagnostic precision and ultimately personalize patient care.”

A Leader in Precision Neuroimaging

The Advanced Parkinson MRI Protocol reflects Miami Neuroscience Institute’s broader efforts in advanced movement disorders care, including deep brain stimulation, high-intensity focused ultrasound, epilepsy surgery and next-generation neuroimaging technologies.

The Institute continues to expand multidisciplinary collaboration between neurology, neuroradiology, neurosurgery and neuroscience research teams to advance both diagnosis and treatment of complex neurologic disorders.

As advanced neuroimaging continues to evolve, the physicians believe protocols like these will become increasingly important in the management of neurodegenerative disease.

“We are moving toward a much more sophisticated era of precision neuroimaging,” Dr. Torres-Russotto said. “The more accurately we can characterize these disorders early in the disease process, the better positioned we are to optimize treatment strategies, counsel patients appropriately and advance research into future therapies.”

Click here to learn more about the Parkinson’s disease treatments and specialists available at Baptist Health Brain & Spine Care.