Objective: We evaluated regional cerebral blood flow (CBF) levels in a cohort of early drug-naïve patients with Parkinson’s disease, and we explored for associations between brain perfusion and integrity of dopaminergic terminals, assessed with [123I]FP-CIT SPECT, and with clinical symptoms.

Background: Studies in vivo in early drug-naïve patients with PD provide important insight into the early pathophysiology of PD. Previous studies, using arterial spin labelling (ASL), have demonstrated increased striatal CBF in PD patients treated with levodopa. Preclinical and clinical studies have shown that dopaminergic treatment increases striatal CBF levels in striatum. Regional brain perfusion and CBF levels are unknown in untreated early patients with PD.

Method: Thirty-three early de novo patients with PD patients and 23 age- and gender-matched healthy controls underwent ASL 3-Tesla MRI, [123I]FP-CIT SPECT, and a thorough battery of clinical assessments.

Results: PD patients showed reduced CBF levels in the putamen (P=0.001), pallidum (P=0.011), substantia nigra (P=0.034), thalamus (P<0.001) and occipital lobe (P<0.001), compared to healthy controls. Reduced CBF levels correlated with lower [123I]FP-CIT Specific Binding Ratio in the putamen (rho=0.56; P=0.006).

Conclusion: This in vivo evidence supports the notion that there is an interaction between vascular and dopaminergic pathology in early PD, thus ASL MRI has the potential to serve as an early biomarker to assess PD pathology in drug-naïve patients with a short disease duration. Abstract also presented at the 2019 European Academy of Neurology conference

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MDS Abstracts - https://www.mdsabstracts.org/abstract/arterial-spin-labelling-detects-subcortical-hypoperfusion-in-early-drug-naive-patients-with-parkinsons-disease/