ArticleQuantitative imaging in medicine and surgery2026
Distinct brain susceptibility alteration pattern in Parkinson's disease with drooling: evidence from quantitative susceptibility mapping.
Article in Quantitative imaging in medicine and surgery, 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
Background: Drooling is a common non-motor symptom in Parkinson's disease (PD) and can substantially impair quality of life, but its underlying neural mechanisms remain incompletely understood. Quantitative susceptibility mapping (QSM) provides a non-invasive approach for assessing susceptibility alterations related to brain iron deposition. This cross-sectional study aimed to investigate QSM-derived susceptibility alterations in PD patients with drooling (PD-DR) and to explore their associations with drooling severity. Methods: A total of 103 participants, including 38 PD-DR, 23 PD patients without drooling (PD-NDR), and 42 healthy controls (HC), underwent three-dimensional (3D) magnetic resonance imaging including regular sequences and QSM. Voxel-wise whole-brain analysis and region of interest (ROI)-based analysis focusing on subcortical nuclei were performed to compare magnetic susceptibility values among groups, with voxel-wise significance set at voxel-level P<0.001 and cluster-level family-wise error-corrected P<0.05. Partial correlation analyses were performed in the PD-DR group to examine associations between susceptibility alterations in identified regions and drooling severity, after adjusting for age, sex, disease stage, and motor severity. Results: Voxel-wise analysis revealed significantly increased susceptibility in the left superior temporal gyrus (STG) in the PD-DR group compared to the PD-NDR group (voxel-level P<0.001, cluster-level family-wise error-corrected P<0.05). In the PD-DR group, susceptibility values in the left STG showed a significant positive correlation with SCS-PD scores after adjusting for age, sex, Hoehn-Yahr stage, and Unified Parkinson's Disease Rating Scale Part III score (r=0.361, P=0.036). Compared to the HC group, the PD-DR group exhibited more widespread cortical susceptibility alterations. ROI analysis indicated higher susceptibility values in the left ventral pallidum (VP) and left parabrachial pigmented nucleus (PBP) in the PD-DR group compared to that in the HC group (Bonferroni-corrected P=0.042 and P=0.043, respectively). Furthermore, susceptibility values in the left PBP were significantly positively correlated with SCS-PD scores (r=0.506, P=0.002). Conclusions: Drooling in PD is associated with a distinct pattern of brain susceptibility alterations, supporting the involvement of a distributed neural network. Key regions include the left STG and the left PBP, which may be related to sensory integration, interoception, motivation, and motor control.
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