Objective: The purpose of this study was to quantitatively characterize simultaneous PET/MR brain changes focusing on the hemispheric asymmetry to trace differences between the more and less affected side, with comparison to a healthy control group.

Background: The diagnostic value of imaging studies in PD is questionable, particularly in early stages.

Method: Fifteen patients with early PD, not yet treated with levodopa, exhibiting persistent asymmetric motor signs from time of presentation and 10 age-matched healthy control’s had simultaneous PET 18F-DOPA and diffusion tensor imaging(DTI)-MRI using a 3T PET/MR scanner. All data underwent voxel based analysis between the more and less affected hemispheres. In addition, structural connectivity network maps were calculated from the DTI images.

Results: Significant differences between the more and less affected hemispheres were found in the striatum, frontal regions, thalamus and cerebellum in fractional anisotropy (5-23%) and PET 18F-DOPA (2-7%), excluding the cerebellum. These differences were not demonstrated for healthy controls. Differences in network analysis were found only in fibers connected to regions of the cerebellum (1-27%). Imaging data did not correlate with lateralized motor scores.

Conclusion: This study demonstrates that multimodal imaging may be sensitive to brain changes beyond the known differences in the striatum. In addition, it suggests that in PD micro-structural differences may be more pronounced than metabolic changes.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/hemispheric-differences-in-motor-circuitry-of-parkinsons-disease-metabolism-and-micro-structure/