Ascending spread models of Parkinson’s disease neurodegeneration remain controversial despite being the dominant model of disease progression in the literature. This study conducted an in vivo evaluation of the ascending spread hypothesis for PD in early and late-stage Parkinson’s disease using measurements of regional grey matter density (GMD) obtained from T1-weighted MRI. Results of this study provide in vivo evidence that regions implicated in stages three and four of the ascending spread model are degenerating ahead of regions implicated in stages five and six. These results further support the proposed ascending pattern of pathological spread in PD.
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