Neuromelanin MRI is useful for monitoring motor complications in Parkinson's and PARK2 disease.
Parkinson's disease (PD) is caused by the loss of dopaminergic neurons. Recently, specific T1-weighted magnetic resonance imaging (MRI) at 3 Tesla was reported to visualize neuromelanin (NM)-related contrast of dopaminergic neurons. Using NM-MRI, we analyzed whether disease severity and motor complications (MC) are associated with the degree of dopaminergic neuronal degeneration in the substantia nigra pars compacta (SNc) in patients with idiopathic PD (PD) and PARK2. We examined 27 individuals with PD, 11 with PARK2, and a control group of 18. A 3T MRI was used to obtain a modified NM-sensitive T1-weighted fast-spin echo sequence. The size of the SNc was determined as the number of pixels with signal intensity higher than background signal intensity +2 standard deviations. NM-MRI indicated that the T1 hyperintense area in the SNc in patients with PD and PARK2 was significantly smaller than that in control subjects. When compared with the PD group without MC, both PD with MC and PARK2 showed a markedly smaller size of NM-rich SNc area. Receiver operating characteristic curve analysis revealed a sensitivity of 86.96% and a specificity of 100% in discriminating between patients with and without MC (area under the curve = 0.98). Correlation analysis between the T1 hyperintense SNc area and L-dopa and L-dopa equivalent dose demonstrated a significant negative correlation. The association between a reducing SNc NM-rich area and MC with increasing dopaminergic medication dose suggests that NM-MRI findings might be a useful tool for monitoring the development of MC in PD and PARK2.
Department of Neurology, School of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan. thatano@juntendo.ac.jp.
Taku
T
Hatano
Department of Neurology, School of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
Ayami
A
Okuzumi
Department of Radiology, School of Medicine, Juntendo University, Tokyo, Japan.
Koji
K
Kamagata
Department of Neurology, School of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
Kensuke
K
Daida
Department of Neurology, School of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
Daisuke
D
Taniguchi
Department of Radiology, School of Medicine, Juntendo University, Tokyo, Japan.
Masaaki
M
Hori
Research Institute for Diseases of Old Age, Juntendo University Graduate School of Medicine, Tokyo, Japan.
Hiroyo
H
Yoshino
Department of Radiology, School of Medicine, Juntendo University, Tokyo, Japan.
Shigeki
S
Aoki
Department of Neurology, School of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan. nhattori@juntendo.ac.jp.|Core Research for Evolutionary Science and Technology (CREST), Japan Science and Technology Agency, Tokyo, Japan. nhattori@juntendo.ac.jp.
Nobutaka
0000-0002-2034-2556
N
Hattori
D000978:Antiparkinson Agents / Q000627:therapeutic use; D019540:Area Under Curve; D015331:Cohort Studies; D003287:Contrast Media; D059290:Dopaminergic Neurons; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008543:Melanins; D008875:Middle Aged; D009043:Motor Activity / Q000187:drug effects; D020734:Parkinsonian Disorders / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000235:genetics / Q000503:physiopathology*; D065842:Pars Compacta / Q000000981:diagnostic imaging*; D012372:ROC Curve; D044767:Ubiquitin-Protein Ligases / Q000235:genetics
D000978:Antiparkinson Agents; D003287:Contrast Media; D008543:Melanins; C014121:neuromelanin; D044767:Ubiquitin-Protein Ligases; C111567:parkin protein
Magnetic resonance imaging; Motor complications; Neuromelanin imaging; PARK2; Parkinson’s disease