Objective: We investigate the relationship  between the contrast ratio of locus coeruleus (LC-CR) in neuromelanin-sensitive MRI(NMI), MIBG scintigraphy, and cognition/hallucination, in patients with Parkinson’s disease.

Background: In recent years-, non-motor symptoms of parkinson’s disease such as olfactory disturbance, depression, RBD, and pain have been attracting an increasing attention. NMI has been reported to be useful for both diagnosis and assessment of disease progression, yet the relationship between NMI, MIBG and cognition  has not been clarified.

Method: Inclusion criteria were as follows: patients with PD who fulfilled the United Kingdom Brain Bank criteria and underwent the examinations that include NMI, MIBG, MoCA-J, pareidoria test, apathy scale and so on at our institution between May 2017 and November 2019. Fifty-eight patients matched these criteria. We assessed NMI by the contrast ratio of substantia nigra (SN) and LC as well as the area of SN same as in our previous reports. We examined the correlation and relevance of each result.

Results: The median age of the patients was 66 years , 41% were male, the median Hoehn-Yahr stage (HY) was 3.2 (1-5), and the median duration was 9.2 years (1-38).
Age was inversely correlated with CES-D, RBMT and MoCA-J , and correlated with the result of pareidoria test and TMT-A. The CR of LC has negative correlation with HY and TMT-A (rs=-0.255, -0.244, p=0.027,0.036, respectively), and has positive correlation with early and delay phase of MIBG (r=0.512, 0.433, p<0.001, 0.001, respectively).  The CR of SN has negative correlation with disease duration, pareidolia test and apathy scale (rs=-0.264, -0.238, -0.258, p=0.023, 0.039, 0.025, respectively), and has positive correlation with early phase of MIBG (r=0.319, p=0.007).

Conclusion: Although age is one of the major factors for cognitive impairment, decease of CR of LC was positively correlated with prolonged TMT-A and negatively correlated both early and delayed phases of MIBG. CR of SN has negatively correlated with apathy scale, underscoring the observation that  supplement of L-dopa sometimes improved apathy state. Moreover, MIBG and NMI are related to some cognitive functions and mood.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/the-relationship-between-neuromelanin-sensitive-mri-123i-meta-iodobenzylguanidine-scintigraphy-and-cognition-in-patients-with-parkinsons-disease/