Zhanhao Mo¹, Lin Liu¹, Lei Zhang¹, Runyu Tang², Yunfei Zhang², Yongming Dai², and He Sui^1
1China-Japan Union Hospital of Jilin University, Jilin, China, ²MR Collaboration, Central Research Institute, United Imaging Healthcare, Shanghai, China

Keywords: Parkinson's Disease, Segmentation

By applying a deep-learning based brain segmentation algorithm on T1-weighted images, the brain was segmented into 106 sub-regions and regional volumes were determined automatically. We analyzed the relationship of brain regional volumes and the severity of Parkinson’s Disease (PD) and compared regional volumes in a cohort of patients with mild and moderate PD. Our data demonstrated that regional volumes of certain brain structures had the potential ability in the characterization of PD.

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Jason Langley¹, Kristy Hwang², Daniel Huddleston³, and Xiaoping Hu^1,4
1Center for Advanced Neuroimaging, University of California Riverside, Riverside, CA, United States, ²2Department of Neurosciences, University of California San Diego, San Diego, CA, United States, ³Department of Neurology, Emory University, Atlanta, GA, United States, ⁴Department of Bioengineering, University of California Riverside, Riverside, CA, United States

Keywords: Parkinson's Disease, Parkinson's Disease, substantia nigra

Neuronal loss in substantia nigra pars compacta is a hallmark of Parkinson's disease. In this abstract, we examine nigral volume in a group without Parkinson's disease (non-carriers, non-manifest LRRK2 and GBA mutations), de novo Parkinson's disease, and moderate Parkinson's disease. Reductions in nigral volume are seen in the Parkinson's disease groups relative to the group without Parkinson's disease. A further reduction is seen in nigral volume of the moderate Parkinson's disease group relative to the de novo group, suggesting that nigral degeneration continues as Parkinson's disease progresses.

Mingrui Qu¹, Bingbing Gao¹, Yuhan Jiang¹, Yuan Li¹, Lizhi Xie², and Yanwei Miao^1
1The First Affiliated Hospital of Dalian Medical University, Dalian, China, ²GE Healthcare, Shanghai, China

Keywords: Parkinson's Disease, Psychiatric Disorders

Depression is the main emotional manifestation associated with Parkinson's disease. The hippocampus is a core region in the limbic system, critical in regulating emotion. This study explored the subregional atrophy pattern of the hippocampus in Parkinson's disease with depression (DPD) patients and its correlation with the severity of depressive symptoms. The results of this study suggest that DPD patients exhibit a left asymmetric atrophy pattern in the hippocampus and its subregions. Partial correlation analysis showed that the left dentate gyrus, left molecular layer, left CA4 and left hippocampal volumes were negatively correlated with Hamilton depression scale scores in DPD patients.

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Paula Trujillo¹, Kilian Hett¹, Kaitlyn R. Hay¹, Alexander K. Song¹, and Daniel O. Claassen^1
1Neurology, Vanderbilt University Medical Center, Nashville, TN, United States

Keywords: Parkinson's Disease, Neuroscience

We investigated the relationship between subregions of the substantia nigra and behavioral disinhibition in patients with Parkinson disease using neuromelanin MRI. We found a significant positive relationship between disinhibition and neuromelanin MRI contrast ratio in bi-lateral clusters localized in the medial substantia nigra. These findings suggest that neuromelanin MRI can be used to assess the localization of changes in the substantia nigra and inform how dopamine pathophysiology relates to behavioral symptoms in Parkinson disease. 

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Yuting Li^1,2, Xiuhang Ruan¹, Yongzhou Xu³, and Xinhua Wei^4
1The Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangzhou, China, ²Affiliated Dongguan Hospital, Southern Medical University (Dongguan People's Hospital), Dongguan, China, ³Philips Healthcare, Guangzhou, China, ⁴Guangzhou First People's Hospital, Guangzhou, China

Keywords: Parkinson's Disease, Parkinson's Disease, drug-naïve Parkinson’s disease, Freezing of gait (FOG)

We developed a model that could predict the occurrence of Freezing of gait (FOG) at the individual level using machine learning with the clinical, laboratory, and cerebral structural imaging information of early drug-naïve Parkinson’s disease (PD) patients. Data from 158 early drug-naïve PD patients at baseline were obtained from the Parkinson’s Progression Markers Initiative cohort. The predictive performance of future FOG in early PD was evaluated using elastic net-support vector machine models. T1WI morphometric markers have the potential to help predict future FOG in patients with early PD at an individual level, with improved performance when integrated with clinical variables.

yuan Tian¹, pengfei Liu¹, and Jianxiu Lian^2
1The First Affiliated Hospital of Harbin Medical University, Harbin, China, ²Philips Healthcare, Beijing, China

Keywords: Parkinson's Disease, Neurodegeneration

Stimulation of the motor cortex (MC) significantly reduce akinesia and bradykinesia in Parkinson Disease (PD), indicating a key role of motor cortex abnormalities in the pathogenesis of PD. Early-onset Parkinson disease (EOPD) , varying between 40 and 55 years of age, it carries additional societal and personal consequences and psychosocial disruption. Thus we aim to explore the cortical gyrification changes as well as their relationships with r-aminobutyric acid (GABA) in the motor cortex(MC) of patients with early-onset Parkinson disease (EOPD). Results showed that decreased in LGI and GABA+/Cr ratios in the motor cortex were found to be slightly coupled.

Amei Chen¹, Junxiang Huang², Xiaofei Huang¹, Xiaofang Cheng³, Yongzhou Xu⁴, and Xinhua Wei^1
1Guangzhou First People's Hospital, Guangzhou, China, ²Guangzhou Women and Children's Medical Center, Guangzhou, China, ³The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China, ⁴Philips Healthcare, Guangzhou, China

Keywords: Parkinson's Disease, Diffusion Tensor Imaging, glymphatic system；rapid movement sleep behavior disorder

To assess the activity of the glymphatic system in PD patients with probably rapid movement sleep behavior disorder (PD-pRBD) using diffusion tensor image analysis along the perivascular space( DTI-ALPS) index. 61 PD-pRBD, 92 PD patients with no probable RBD(PD-npRBD) and 59 healthy control (HC) were included in the study. The results showed that the ALPS index in PD-pRBD group was lower than that in PD-npRBD group. The index of ALPS in PD-pRBD was negatively correlated with REM sleep behavior disorder screening questionnaire(RBDSQ) score. We concluded that the glymphatic system function of PD with RBD is impaired.

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Yao-Chia Shih^1,2,3, Pohchoo Seow², Hu-Lin Christina Wang^1,4, Aeden Zi Cheng Kuek², Septian Hartono^3,5, Sui-Hing Yan⁶, Eng King Tan^3,5, and Ling Ling Chan^2,3
1Graduate Institute of Medicine, Yuan Ze University, Taoyuan City, Taiwan, ²Department of Diagnostic Radiology, Singapore General Hospital, Singapore, Singapore, ³Duke-NUS Medical School, Singapore, Singapore, ⁴Department of Traumatology, Far Eastern Memorial Hospital, New Taipei City, Taiwan, ⁵Department of Neurology, National Neuroscience Institute – SGH Campus, Singapore, Singapore, ⁶Department of Neurology, Far Eastern Memorial Hospital, New Taipei City, Taiwan

Keywords: Parkinson's Disease, Diffusion Tensor Imaging

The present study systematically and comprehensively reviewed the axonal pathways projecting from the deep brain nuclei that are emerging targets for treating Parkinson’s disease (PD). We tracked 124 deep brain nuclear pathways across different neurotransmitters systems in the high angular HCP-1065 diffusion MRI template using diffusion MRI tractography. With the trajectories of these pathways, we successfully used Parkinson's Progression Markers Initiative (PPMI) diffusion tensor imaging (DTI) data to characterize abnormal DTI changes in noradrenergic and serotoninergic pathways in relation to the severity of non-motor symptoms in de novo PD patients, suggesting a wide neural involvement of clinical PD manifestations.

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Hui Li¹, Chen Zhang², Xiuqin Jia¹, and Qi Yang^1
1Department of Radiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China, ²MR Scientific Marketing, Siemens Healthineers, Beijing, China

Keywords: Parkinson's Disease, Parkinson's Disease, sex difference, brain structure, cross-sectional, longitudinal

The aim of this study was to investigate sex differences in brain structure at baseline and sex differences in longitudinal changes at follow-up between female and male PD patients after excluding the expected effects of age and sex. At baseline, male PD patients exhibited significantly lower brain volume and decreased cortical thickness than age-matched female PD patients. At follow-up, these sex differences remained stable and analogous progressive brain atrophy with no sex interaction were found in male and female PD patients, suggesting similar trend in disease progression between sexes over time.

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Hacer Dasgin¹, Basak Soydas Turan², Bilge Volkan Salanci³, Eser Lay Gun², Gul Yalcin Cakmakli³, Bulent Elibol³, and Kader K. Oguz^1,4,5
1Umram, Bilkent University, Ankara, Turkey, ²Faculty of Medicine, Department of Nuclear Medicine, Hacettepe University, Ankara, Turkey, ³Faculty of Medicine, Department of Neurology, Hacettepe University, Ankara, Turkey, ⁴Faculty of Medicine, Department of Radiology, Hacettepe University, Ankara, Turkey, ⁵University of California, Davis, CA, United States

Keywords: Parkinson's Disease, fMRI (resting state)

Clinical presentation of monogenic PD differs from idiopathic PD, which might relate to different structural and functional alterations. Previously, we examined a small group of genetic PD patients with connectivity changes in the  basal ganglia, compared with healthy control (HC)s. In this study we further examined monogenic PD patients and compared  idiopathic PD group and HCs that functional and microstructural changes would be different in these groups of patients. There was no significant basal ganglia network (BGN) alteration between PD groups, but ACC activation is remarkable in both groups. Significantly decreased fractional anisotropy in mPD patients compared to iPD patients.

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Naying He¹, Ewart Mark Haacke^1,2, Ying Wang², Youmin Zhang¹, Xinhui Wang¹, Zhijia Jin¹, Yan Li¹, Peng Wu³, and Fuhua Yan^4
1Ruijin Hospital, Shanghai Jiao Tong University, Shanghai, China, ²SpinTech MRI, Bingham Farms, MI, USA 48025, Bingham Farms, MI, United States, ³Philips Healthcare, Shanghai, China, ⁴Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

Keywords: Parkinson's Disease, Neurodegeneration

Diagnosing movement disorders (MDS) is a major challenge clinically. Neuromelanin and iron serve as biomarkers for MDS but few studies have evaluated a large number of cases for multiple disorders. We studied 614 patients consisting of two cohorts with different resolutions. The QSM and NM-MRI data were automatically processed using a unique template program. The results from both cohorts showed reproducible changes of iron and neuromelanin in the deep gray matter. Specifically, a loss of neuromelanin volume, an increase in iron content of the SN for both PD and MSA; increased RN iron and decreased putamen volume in MSA.

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Minjun Kim¹, Sooyeon Ji¹, Joonhyeok Yoon¹, Hwihun Jeong¹, Hongjun An¹, Jiye Kim¹, Jonghyo Youn¹, Junghwa Kang², Eung Yeop Kim³, Yoonho Nam², and Jongho Lee^1
1Department of Electrical and Computer Engineering, Seoul National University, Seoul, Korea, Republic of, ²Department of Biomedical Engineering, Hankuk University of Foreign Studies, Gyeonggi-do, Korea, Republic of, ³Department of Radiology, Samsung Medical Center, Seoul, Korea, Republic of

Keywords: Parkinson's Disease, Parkinson's Disease

Neuromelanin MRI signal decreases in IPD patients in the substantia nigra. In this study, we investigated that the decrease is caused by not only the reduction of neuromelanin but also iron deposition. Neuromelanin reduction in IPD patients was shown by the result of the substantia nigra volume decrease. The comparison result of contrast ratio, calculated between substantia nigra and crus cerebri, of IPD patients versus healthy controls demonstrated that iron deposition also decreases the signal of NM-MRI. T₂*, susceptibility, and overlapped area between substantia nigra from neuromelanin MRI and hypo-intense area from SMWI also represented the tendency of iron deposition.

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Septian Hartono^1,2, Robert Chen³, Thomas Welton¹, An Sen Tan³, Weiling Lee³, Peik Yen Teh³, Celeste Chen¹, Wenlu Hou³, Wei Ping Tham³, Ee Wei Lim¹, Prakash Kumar¹, Yao-Chia Shih⁴, Kuan Jin Lee⁵, Louis Chew Seng Tan¹, Eng King Tan¹, and Ling Ling Chan^3
1National Neuroscience Institute, Singapore, Singapore, ²Duke-NUS Medical School, Singapore, Singapore, ³Singapore General Hospital, Singapore, Singapore, ⁴Yuan Ze University, Taoyuan, Taiwan, ⁵Institute of Bioengineering and Bioimaging, Singapore, Singapore

Keywords: Parkinson's Disease, Parkinson's Disease

Nigrosome-1, a subregion of substantia nigra (SN), and neuromelanin have been identified as good biomarkers of Parkinson's disease (PD) pathology. We investigated the diagnostic accuracy of quantitative iron-neuromelanin parameters and compared these against visual analysis of nigrosome-1 and neuromelanin hyperintensity as proxies of nigral dopaminergic neurodegeneration. Susceptibility map-weighted imaging surpassed neuromelanin sensitive MRI in blinded visual PD classification; reader expertise affected performance. Composite quantitative iron-neuromelanin marker matched diagnostic accuracy of expert reader in visual evaluation of nigrosome-1 using susceptibility map-weighted imaging, potentially improving diagnostic confidence in non-experts. Quantitative susceptibility mapping showed moderate negative correlation with motor dysfunction in PD patients.

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Xinhui Wang¹, Naying He¹, Ewart Mark Haacke², Yu Liu¹, Peng Liu¹, Youmin Zhang¹, Zhijia Jin¹, Yan Li¹, Peng Wu³, and Fuhua Yan^1
1Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China, ²Biomedical Engineering, Wayne State University, Detroit, MI, United States, ³Philips Healthcare, Shanghai, China

Keywords: Parkinson's Disease, Brain, essential tremor; neuromelanin MRI; locus coeruleus;substantia nigra

In this study, we used neuromelanin MRI to investigate locus coeruleus (LC) and substantia nigra changes between essential tremor (ET) and Parkinson’s disease (PD). We found the neuromelanin of LC was significantly lower in tremor-dominant PD patients than in ET patients or healthy controls, and the area under the curve of the model constructed by NM measures reached 0.92 in differentiating tremor-dominant PD from ET. These results provided new perspectives in the differential diagnosis of patients with tremor and in the investigation of the underlying pathophysiology.

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Dafa Shi¹, Haoran Zhang¹, Guangsong Wang¹, and Ke Ren^1
1Department of Radiology, Xiang’an Hospital of Xiamen Uneversity,School of Medicine, Xiamen University, Xiamen, China

Keywords: Parkinson's Disease, Brain Connectivity

Development of more clinically effective and quantifiable biomarkers to detect PD is urgently needed. It confirmed that  regional radiomics similarity network (R2SN) had high reproducibility and a biological basis and provided a new perspective for understanding the human brain. Our study showed that R2SN constructed based on ALFF had good reproducibility and stability, and is  biological plausibility. We found PD-related brain regions mainly located in the default-mode, sensorimotor, executive control, visual, frontoparietal network, as well as cerebellum, and striatum. ALFF-based R2SN is a novel, robust potential neuroimaging biomarker for PD and could provide new insights into connectome reorganization in PD.

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Peng Liu¹, Naying He¹, Youmin Zhang¹, Caixia FU², Qing Li³, E. Mark Haacke⁴, Yu Liu¹, Wei Liu², Xinhui Wang¹, Daniel Polak⁵, and Fuhua Yan^1
1Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China, ²Siemens Shenzhen Magnetic Resonance Ltd., Shenzhen, China, ³Siemens Healthineers Ltd., Shanghai, China, ⁴Wayne State University, Detroit, MI, United States, ⁵Siemens Healthcare GmbH, Erlangen, Germany

Keywords: Parkinson's Disease, Data Acquisition, Magnetic resonance imaging, Nigrosome-1, Susceptibility Weighted Imaging

In this work, the ability of Wave-CAIPI accelerated 3D SWI for imaging the Nigrosome-1(N1) sign was evaluated. Short-TE, long-TE and conventional SWI protocols were compared for the detection of the N1 sign. Qualitative and quantitative analyses were used to evaluate the presence or absence of the N1 sign and the contrast-to-noise (CNR) of the N1 sign relative to adjacent tissues. The results showed that Wave-CAIPI SWI had no significant differences with conventional SWI for recognizing the N1 sign. Wave-CAIPI SWI can be a replacement of conventional SWI (4 min 52s) with shorter scan times of 2min 26s covering the whole brain.

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Ruxanda Lungu Baião¹, Tiago Fleming Outeiro², and Noam Shemesh^1
1Preclinical MRI, Champalimaud Research, Champalimaud Foundation, Lisbon, Portugal, ²Department of Experimental Neurodegeneration, University of Göttingen, Goetingen, Germany

Keywords: Parkinson's Disease, Neurodegeneration

Parkinson's disease (PD) is associated with irreparable damage to dopaminergic neurons due to α-synuclein (aSYN) inclusions. Dopaminergic pathways include the nigrostriatal, mesolimbic, mesocortical and tuberoinfundibular systems that play vital roles. Thus, dysregulations of dopamine function may lead to brain-wide consequences. Apart from a mouse PD model of injected aSYN1, brain morphology alterations in genetic mouse models have not been described in detail using MRI. Here we explore brain morphological differences between PD models and healthy controls, crucial for further understanding of the disease. We find major morphological abnormalities in areas such as Lateral Ventricles, Corpus Callosum and the surrounding Cortex.

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Miguel López-Aguirre^1,2,3, Michele Matarazzo^1,3, Javier Blesa^1,3, Álvaro Sánchez-Ferro^1,4, Mariana H.G. Monje^1,5, José A. Obeso^1,3,6, and José A. Pineda-Pardo^1,3,6
1HM CINAC, Hospital Universitario HM Puerta del Sur, Móstoles, Spain, ²Universidad Complutense de Madrid, Madrid, Spain, ³Center for Networked Biomedical Research on Neurodegenerative Diseases (CIBERNED), Instituto de Salud Carlos III, Madrid, Spain, ⁴Neurology Department, Hospital Universitario 12 de Octubre, Madrid, Spain, ⁵Ken and Ruth Davee Department of Neurology, Northwestern University, Chicago, IL, United States, ⁶Universidad San Pablo-CEU, Madrid, Spain

Keywords: Parkinson's Disease, Multimodal, Dopamine, free-water DTI, Iron

FDOPA uptake rate, fractional volume of free-water and R2* relaxometry are imaging biomarkers sensitive to dopaminergic decline, microstructural degeneration, and iron disruption respectively, three pathological processes developed within the nigrostriatal system in Parkinson’s disease (PD). A multimodal comprehensive characterization of these biomarkers in early PD was performed, assessing them within striatum and substantia nigra pars compacta in a de novo PD cohort. While iron disruption was not observed, PD subjects revealed dopaminergic and microstructural alterations within the nigrostriatal system, following both similar spatial patterns. These results serve to improve our understanding of nigrostriatal vulnerability and degeneration in early PD.

Xueling Liu¹, Yuxin Li¹, Puyeh Wu², Na Wang¹, Fengtao Liu³, and Daoying Geng^1
1Radiology Department of Huashan Hospital affiliated to Fudan University, Shanghai, China, ²GE healthcare, Beijing, China, ³Neurology Department of Huashan Hospital affiliated to Fudan University, Shanghai, China

Keywords: Parkinson's Disease, Neurodegeneration, neuromelanin

The bilateral neuromelanin degeneration pattern in substantia nigra in normal aging and underlying mechanisms of asymmetric motor symptoms in early Parkinson’s disease (PD) are still unknown. Here we examined the neuromelanin hemispheric asymmetry in normal elderly people and early PD patients with motor symptoms laterality by short-echo-time magnitude images derived from QSM. We demonstrated hemispheric asymmetry of neuromelanin in normal aging, as well as a left-hemispheric preferential nigral dysfunction in early-stage PDR, but a different spatial neuromelanin loss pattern in PDL. This template-based neuromelanin measurement might help to detect aging-related change and deepen our understanding of PD with motor laterality.