The Predictive Value of the Substantia Nigra and Locus Coeruleus Volumes Using 3D Neuromelanin-sensitive MRI to...

To explore the relationship between the substantia nigra and the locus coeruleus volumes (SNV and LCV, respectively) measured with 3D neuromelanin-sensitive magnetic resonance imaging (NMI) and motor/non-motor symptoms after deep brain stimulation (DBS) in patients with advanced Parkinson's disease (PD).

The cohort included 34 patients with PD who underwent subthalamic DBS and seven healthy controls. SNVs and LCVs were measured in 3D NMI images. The association of SNVs and LCVs with the clinical characteristics was evaluated using partial correlation analyses, controlling for age and disease duration, with p-values adjusted using the Bonferroni correction. Pre-DBS dopamine transporter (DAT)-specific binding ratio (SBR) was also evaluated.

SNV and LCV were significantly smaller in the PD group than in the control group. After adjusting for covariates and multiple comparisons, SNV showed no significant correlations with the clinical scores. However, LCV exhibited significant negative correlations with the pre-DBS PDSS-2 score (r=-0.585, adjusted p=0.004) and the 1-year post-DBS PDQ-39 mobility score (r=-0.557, adjusted p=0.003). In contrast, the pre-DBS DAT SBR was significantly correlated with execution time on the pre-DBS TMT-A (r=-0.575, adjusted p=0.006) and the 1-year post-DBS RCPM score (r=0.491, adjusted p=0.044).

3D NMI provides prognostic information in advanced PD, complementing DAT SPECT. LCV correlates with sleep quality and the mobility-related quality of life after DBS, whereas DAT SBR sensitively reflects cognitive processing speed and visuospatial abilities.