Evaluation of the correlation of neuromelanin loss in the Substantia Nigra on MRI with disease stage in idiopathic Parkinson's patients and investigation of its place in differential diagnosis in patients with Parkinson Plus Syndrome

Evaluation of the Correlation of Neuromelanin Loss in the Substantia Nigra on MRI with Disease Stage in Idiopathic Parkinson's Patients and Investigation of its Place in Differential Diagnosis in Patients with Parkinson Plus Syndrome. Our aim in this study is to contribute to improving the diagnosis and differential diagnosis of Parkinson's disease. In outpatient clinic applications, in patients with a preliminary diagnosis of IPD or Parkinson Plus Syndrome and referred to MRI; It was aimed to examine the loss of neuromelanin on MRI during control examinations, whether this loss is correlated with the disease stage in IPD, and whether neuromelanin MRI imaging affects Parkinson Plus Syndromes and whether it can be used in the differential diagnosis of IPD. This study was planned as retrospective and cross-sectional; Who applied to Akdeniz University Hospital Faculty of Medicine Neurology outpatient clinic between 30.09.2020 and 04.05.2023 for routine check-ups; People aged 18 years and over, those diagnosed with IPD in accordance with UKBBPDS criteria and those clinically diagnosed with Parkinson Plus Syndrome, and those without neurodegenerative disease as the control group were included. Care was taken to ensure that the people included in the study had Neuromelanin-MRI performed as neuroimaging in the system. Hoehn & Yahr Staging and UPDRS were performed for idiopathic Parkinson's patients to stage the disease. In our study, visual evaluation; on the right and left sides; The rate of lateral and median loss was found to be significantly higher in people with IPD than in the control group. There was no difference in right and left medial loss. When examined with ROI-SI, there were no regional differences between the groups, and no difference was found when comparing the ipsilateral crus cerebri. In our study, visual inspection; The rate of right lateral, median and medial loss was found to be significantly higher in individuals with IPH compared to MSA and PSP groups. In individuals evaluated as IPD; It was observed that the disease stage and loss found by Hoehn & Yahr and UPDRS were not correlated with each other both in visual examination and in ROI-SI examination. When MSA types were evaluated among themselves with ROI-SI, more median and medial loss was found in right-sided MSA-P patients compared to MSA-C. The data obtained from our study, as a result of visual evaluation in Idiopathic Parkinson's Patients; It shows that there is a loss in the lateral and median regions in distinguishing it from normal individuals, and in addition, unlike other Parkinsonism groups, it was concluded that it showed a loss in all regions. There is a need for imaging biomarkers to improve diagnosis in idiopathic Parkinson's Disease patients and to differentiate between Primary Parkinsonism Patients presenting at an early stage. Key Words: Idiopathic Parkinson's Disease, Parkinson Plus Syndromes, Neuromelanin-MRI