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In normal physiologic state, the brain parenchyma is only subject to nascent immune surveillance, however during inflammation, the elevated pro-inflammatory markers induce the increased expression of adhesion molecules like intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) on the endothelial cells of the BBB (Varatharaj and Galea, 2017

In a multicenter PPMI cohort, free water in the posterior region of the SN increased in de novo PD from baseline to 1, 2, and 4 years, and changes in free water within 1 year predicted changes in the Hoehn & Yahr scale at 4 years ( 7.3 Imaging markers based on molecular imaging By tagging synapses, neurotransmitters, and glucose transporters at the molecular level, positron emission tomography (PET) and single photon emission computed tomography (SPECT) are common molecular imaging techniques to reflect cerebral functional changes

Obtaining detailed drug history and personal history are significantly important to assess the risk even with acetaminophen which is a commonly used drug in the absence of other metabolic causes

doi: 10.1056/NEJMoa054022

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