White matter microstructural changes in relation to the neurotransmitter systems in Parkinson’s disease (PD) progression remains unclear. We used diffusion spectrum imaging and local connectome fingerprint analysis to investigate microstructural integrity of the the premotor and motor pathways in associations with various neurotransmitter systems in the brainstem, and disease duration and severity of motor-related symptoms. We found greater microstructural changes in the dopaminergic pathways in association with motor progression than for the other neurochemical pathways. Patients with longer disease duration or more severe motor dysfunctions showed increased anisotropic water diffusion in these pathways, suggesting a compensatory effect of axonal sprouting.
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