Parkinson's disease (PD) and idiopathic rapid eye movement sleep behaviour disorder (iRBD, a prodromal condition of Parkinsonism) are characterised by progressive striatal dopaminergic denervation, loss of neuromelanin-containing neurons and increased iron deposition in the substantia nigra. Here, we evaluated neurodegeneration-induced changes in the nigrostriatal system of PD and iRBD patients using longitudinal SPECT and MR imaging compared to healthy control subjects. We showed that dopamine, neuromelanin and iron changes followed similar spatiotemporal gradients of neurodegeneration, and we assessed the temporal onset and ordering of such changes.
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