Fig. 1 Brain MRI and FP-CIT PET imaging of the patient. a, b Brain MRI with T2-weighted axial images show typical bilateral high signal intensity at both medulla oblongata and cerebellar dentate nuclei. c No major lesions in the basal ganglia and periventricular white matter. d A T1-weighted sagittal image shows tadpole shape cervicomedullary atrophy. e 3-dimensional [18F] FP-CIT PET shows severely decreased dopaminergic uptake in bilateral putamen and caudate nucleus with a rostrocaudal gradient. f FP-CIT PET in control shows normal dopaminergic uptake in bilateral putamen and caudate nucleus