ArticleNPJ Parkinson's disease2026
Differentiating tremor-dominant parkinson's disease from essential tremor using neuromelanin- sensitive imaging and T1w/T2w ratio.
Article in NPJ Parkinson's disease, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Parkinson's disease (PD) and essential tremor (ET) are the most common movement disorders and share tremor symptom. This study aimed to differentiate tremor-dominant PD (TD-PD) from ET using neuromelanin-sensitive MRI (NM-MRI) and T1w/T2w ratio. We included 117 TD-PD, 43 ET with resting tremor (r-ET), 94 ET without resting tremor (nr-ET) patients, and 81 healthy controls (HC). Contrast-to-noise ratios (CNR) in the locus coeruleus (LC) and substantia nigra (SN) were calculated from NM-MRI, while T1w/T2w ratios were derived from T1- and T2-weighted images in PD- and ET-related pathological regions. TD-PD patients exhibited significantly lower CNR values in the LC and bilateral SN compared to the other three groups (all p < 0.05), with the r-ET group showing intermediate values between TD-PD and nr-ET. All patient groups demonstrated higher T1w/T2w ratio compared to HC (p < 0.05), following a consistent pattern of TD-PD > r-ET > nr-ET across most regions of basal ganglia and cerebellar structures. Combining NM-MRI with T1w/T2w ratio analysis improved differentiation efficiency, with AUCs of 0.798 (TD-PD vs r-ET) and 0.851 (TD-PD vs nr-ET). The intermediate imaging profile of r-ET suggests a potential pathophysiological overlap with TD-PD.
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