Objective: This study aimed to examine the relationship between findings of neuromelanin sensitive MRI findings and motor complications. We also examined the correlation of findings of dopamine transporter scintigraphy and those of neuromelanin-sensitive MRI as a promising noninvasive alternative.

Background: Several studies have implicated presynaptic dopamine dysregulation as a cause of motor fluctuations in Parkinson’s disease(PD). Neuromelanin MRI is capable of directly examining neuronal loss in substantia nigra(SN), and thus as it might be an excellent means to predict MF. We examined the relationship between MF and neuroimaging. Dopamine transporter SPECT(DAT-SPECT) with 123I-FP-CIT is used in the detection of presynaptic dopamine disorders, but invasive due to radiation exposure, whereas neuromelanin MRI is a noninvasive promising new diagnostic imaging technique.

Methods: Subjects were 35 PD patients (60±13 years,with 23 men), who visited our hospital between April 2014 and March 2015 and 23 healthy adults as a control (59±19 years,11 men). Patient characteristics and findings of neuromelanin MRI and DAT-SPECT were analyzed. The relationship with image findings were examined in 2 groups divided according to the with or without of motor fluctuations. Multivariate analysis was performed using the Cox proportional hazard model to screen for prognostic factors.

Results: Neuromelanin MRI revealed that the hyperintense SN area was significantly reduced in the group with motor fluctuations than in that without (p<0.001). On the other hand, there was no significant difference observed between 2 groups on specific binding ratio (SBR) (p=0.364). Multivariate Cox regression analysis revealed that the hyperintense SN area was a significant prognostic factor for the onset of motor fluctuations (hazard ratio0.95; p=0.018). SBR correlation was observed between hyperintense SN area (Spearman correlation, r=0.43, p=0.03).

Conclusions: Loss of melanin signal correlated with disease progress,suggesting its possible use as a predictive marker for the onset of MF. Furthermore, we observed SBR correlation between the hyperintense SN area.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/prognostic-factors-of-motor-symptoms-in-parkinsons-disease-using-neuromelanin-imaging-and-the-relationship-with-123i-fp-cit-spect/