Abstract
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.
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This study was supported by a Strategic Research Foundation Grant-in-Aid for Private Universities, and Grants-in-Aid for Scientific Research on Priority Areas (to TH, 25461290 and to NH, 24390224); by the Brain Mapping by Integrated Neurotechnologies for Disease Studies Project (to SA and NH); by a Japan Science and Technology Agency Grant for the creation of innovative technology for medical applications based on the global analyses and regulation of disease-related metabolites (to NH); by Japan Agency for Medical Research and Development for Promoting Clinical trials for development of New Drugs and Medical Devices (to NH); by Grants-in-Aid from the Research Committee of CNS Degenerative Diseases, the Ministry of Health, Labour and Welfare of Japan (to NH), and by Ministry of Health, Labour and Welfare specific disease treatment research project Grant (to NH).
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None of the authors have any financial disclosure to make or have any conflict of interest.
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T. Hatano and N. Hattori contributed equally to the manuscript.
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Hatano, T., Okuzumi, A., Kamagata, K. et al. Neuromelanin MRI is useful for monitoring motor complications in Parkinson’s and PARK2 disease. J Neural Transm 124, 407–415 (2017). https://doi.org/10.1007/s00702-017-1688-9
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DOI: https://doi.org/10.1007/s00702-017-1688-9