The Buffalo Neuroimaging Analysis Center (BNAC) is a dedicated research center that has expertise in Parkinson’s disease clinical trials. Our team uses both qualitative and quantitative analysis of magnetic resonance imaging (MRI), positron emission tomography (PET) and optical coherence tomography (OCT) to better understand its onset, progression, and treatment. We served as Clinical Core Lab for a number of Parkinson’s disease clinical trials. 

Lesion Related Outcomes

BNAC is a world leader in evaluation of white matter pathology in neurodegenerative diseases. BNAC uses a three-level quality control system where scans are reviewed by multiple expert evaluators and the resulting gold-standard regions of interest (ROIs) are painstakingly edited to ensure the highest possible accuracy. In addition, BNAC has also been working to augment expert raters with deep learning systems in clinical trial workflows to improve overall quality of lesion detection. The high quality of BNACs three-level quality control system provides unparalleled training data for us to teach artificial intelligence (AI) systems to identify and delineate brain regions and areas of pathology. By feeding this back into clinical trial activities, we are able to augment human operators to further improve precision of lesion delineation and accuracy of lesion detection and maximize study power.

Central Nervous System Atrophy

This research helps discover the causes and progression of neurodegenerative changes in diseases like Parkinson’s. Additionally, new measurement methods for real-world clinical use, such as the NeuroSTREAM platform, are created through this research. 

Microstructual Changes

BNAC is using a variety of imaging measures to evaluate microstructural damage in the central nervous system (CNS). Among others, these include magnetization transfer, diffusion tensor imaging, spectroscopy, quantitative susceptibility mapping and perfusion.

In particular, we conducted clinical trials in Parkinson’s disease using a novel imaging biomarker, the free water in the posterior substantia nigra obtained from a bi-tensor model fit of in vivo diffusion MR imaging. This imaging measure has been shown to significantly increase in patients with early stage idiopathic Parkinson’s disease compared with healthy controls, which suggests that posterior substantia nigra free water may be an important progression biomarker. Due to the known posterior-to-anterior temporal evolution of substantia nigra degeneration in idiopathic Parkinson’s disease, the longitudinal changes in free water in both the posterior and anterior substantia nigra in patients may be also a promising biomarker in later-stage idiopathic Parkinson’s disease.

Brain Connectomics

Our brain connectomics work uses state-of-the art structural and functional MRI connectivity measurements to help better understand neuroplasticity, recovery, and cognition.

Optical Coherence Tomography

Our optical coherence tomography (OCT) research has shed new light on neurodegenerative central nervous system processes.

Radiotracers and PET Imaging

Our novel work with radiotracers and positron emission tomography (PET) Imaging has expanded the understanding of molecular drivers in neurodegenerative disease progression and pathology. 

For more information about imaging endpoints, click here.


  • Guttuso T, Jr., Shepherd R, Frick L, Feltri ML, Frerichs V, Ramanathan M, Zivadinov R, Bergsland N. Lithium’s effects on therapeutic targets and MRI biomarkers in Parkinson’s disease: a pilot clinical trial. IBRO Neurosci Rep 2023:7;14:429-434. [Open Article]

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Part of BNAC’s mission is to help share our tools and experience with our colleagues and other industry partners. If you need help with managing a medical imaging trial related to Parkinson’s disease, please reach out to discuss how we can assist. Our group brings decades of experience and expertise to every collaborative study and service partnership.