Objective: To characterize region-specific cerebral perfusion alterations within the basal ganglia in patients with early-stage Parkinson’s disease using quantitative CT perfusion imaging.

Background: Emerging evidence implicates neurovascular dysfunction as a pathophysiologically relevant — and potentially early — feature of Parkinson’s disease. Perfusion-sensitive imaging modalities offer the capacity to detect functional microvascular changes within nigrostriatal circuits before macrostructural degeneration becomes evident, raising the possibility of perfusion-based biomarker development in this population.

Method: A retrospective case-control study was performed including 96 participants: 52 patients with clinically confirmed early Parkinson’s disease and 44 cognitively and demographically matched controls who had undergone CT perfusion imaging for non-neurodegenerative clinical indications. Quantitative perfusion parameters — cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT) — were extracted from the posterior putamen, caudate nucleus, and globus pallidus using standardized region-of-interest methodology. Motor severity was characterized by UPDRS-III scoring. Between-group perfusion differences and clinicoimaging correlation analyses were performed.

Results: Patients with early Parkinson’s disease demonstrated significantly reduced CBF within the posterior putamen compared with controls (p < 0.01), accompanied by prolonged MTT across the broader basal ganglia territory. Putaminal hypoperfusion correlated inversely and significantly with UPDRS-III motor scores (r = −0.41, p < 0.01), indicating that perfusion reduction tracked with clinical severity. Cortical perfusion parameters did not differ significantly between groups, suggesting subcortical functional specificity of these early changes.

Conclusion: Quantifiable perfusion deficits, particularly within the posterior putamen, are detectable in early Parkinson’s disease using CT perfusion imaging and correlate with motor impairment severity. These findings advance understanding of early neurovascular dysfunction in Parkinson’s disease and support the exploration of perfusion imaging as a clinically accessible, functionally sensitive biomarker for disease characterization and monitoring.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/regional-basal-ganglia-hypoperfusion-in-early-parkinsons-disease-evidence-from-ct-perfusion-imaging/