Brain structural and functional alteration in movement disorders: A narrative review of markers and their dynamic changes

Movement disorders can present a significant challenge to healthcare professionals due to their varied etiologies, complex symptomatology, and often debilitating consequences for patients by affecting their quality of life. Functional imaging in movement disorders has demonstrated alterations in the neural activation patterns within the motor networks, thus offering clues toward understanding the molecular basis for motor deficits. This review aims to describe changes in brain structure and function in movement disorders. On that account, the combination of structural and functional imaging of movement disorders provides better diagnostic outcomes. Furthermore, new magnetic resonance imaging technology such as diffusion tensor imaging has shown disconnection of white matter tracts and alterations in connectivity. The investigations into the structural and functional changes of the brain in the context of movement disorders also help understand neuroplasticity, which preserves motor function. Interestingly, functional magnetic resonance imaging has revealed that patients with Parkinson’s disease tend to have higher cortical activity in areas such as the primary motor cortex, to counteract the loss of dopaminergic neurons. Likewise, research has demonstrated that patients with Huntington’s disease exhibit altered connectivity patterns between the motor cortex and basal ganglia to mitigate striatal loss. However, these compensatory changes may eventually be overcome as the disease progresses, leading to clinical symptoms. Thus, it is logical to conclude that understanding the underlying structural and functional alterations in the brain associated with these disorders is crucial for accurate diagnosis, effective management, and the development of targeted therapeutic interventions.