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• Clinical Article •
Substantia nigra and locus coeruleus neuromelanin magnetic resonance imaging differentiates Parkinson's disease and multiple system atrophy
LIU Yu  HE Naying  YAN Fuhua 

Cite this article as: LIU Y, HE N Y, YAN F H. Substantia nigra and locus coeruleus neuromelanin magnetic resonance imaging differentiates Parkinson's disease and multiple system atrophy[J]. Chin J Magn Reson Imaging, 2025, 16(4): 6-11. DOI:10.12015/issn.1674-8034.2025.04.002.


[Abstract] Objective To use neuromelanin (NM)-MRI of the substantia nigra (SN) and locus coeruleus (LC) to compare NM loss in patients with Parkinson's disease (PD) and multiple system atrophy (MSA).Materials and Methods A total of 114 subjects (including 38 patients with PD, 38 patients with MSA, and 38 age-matched healthy controls (HCs) were retrospectively collected. In the first part, voxels-of-interests (VOIs) of the bilateral SN were automatically traced based on a brain template detection method. Relative contrast ratio (rCR), volume and corrected volume (SN volume divided by the total intracranial volume) of the SN territory were measured. In the second part, rCR of the LC was measured using manually drawn regions-of-interests (ROIs) within the structure. One-way analysis of variance combined with Bonferroni correction was used to conduct post-hoc multiple comparisons to analyze the intergroup differences of the NM-related parameters. The NM parameters of the SN and LC were combined to generate a model using logistic regression method. Receiver operating characteristic (ROC) curve was used to evaluate the diagnostic performance of different single NM parameters and logistic regression model, and the area under the curve (AUC) was calculated.Results Compared to HCs, volume, corrected volume and rCR of the SN, and rCR of the LC were significantly reduced in PD and MSA patients (Bonferroni correction, all P < 0.001). Of note, MSA had significantly lower SN volume and LC rCR than PD (Bonferroni correction, P < 0.001, respectively). The AUC of the corrected volume of the SN to distinguish MSA and HC, PD and HC reached as high as 0.981 and 0.950, respectively. The AUC of the logistic regression model combining the NM measurement of the SN and LC to distinguish MSA and PD reached 0.817.Conclusions The NM volume and contrast measures of the SN and contrast measures of the LC provided subjective and quantitative information to better facilitate differential diagnosis between PD and MSA.
[Keywords] Parkinson's disease；multiple system atrophy；magnetic resonance imaging；neuromelanin；substantia nigra；locus coeruleus

LIU Yu   HE Naying   YAN Fuhua*  

Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200001, China

Corresponding author: YAN F H, E-mail: yfh11655@rjh.com.cn

Conflicts of interest   None.

Received  2025-01-16
Accepted  2025-03-10
DOI: 10.12015/issn.1674-8034.2025.04.002
Cite this article as: LIU Y, HE N Y, YAN F H. Substantia nigra and locus coeruleus neuromelanin magnetic resonance imaging differentiates Parkinson's disease and multiple system atrophy[J]. Chin J Magn Reson Imaging, 2025, 16(4): 6-11. DOI:10.12015/issn.1674-8034.2025.04.002.

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