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In Parkinson disease (PD) patients, NM concentration decreases gradually with degeneration and necrosis of dopamine neurons, suggesting potential use as a PD biomarker. We aimed to evaluate associations between NM concentration in in vivo SN and PD progression and different motor subtypes using NM magnetic resonance imaging (NM-MRI). Fifty-four patients with idiopathic PD were enrolled. Patients were divided into groups by subtypes with different clinical symptoms: tremor dominant (TD) group and postural instability and gait difficulty (PIGD) group. Fifteen healthy age-matched volunteers were enrolled as controls. All subjects underwent clinical assessment and NM-MRI examination. PD patients showed significantly decreased contrast-to-noise ratio (CNR) values in medial and lateral SN (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05) compared to controls. CNR values in lateral SN region decreased linearly with PD progression (<jats:italic>P<\/jats:italic>\u2009=\u20090.001). PIGD patients showed significant decreases in CNR mean values in lateral SN compared to TD patients (<jats:italic>P<\/jats:italic>\u2009=\u20090.004). Diagnostic accuracy of using lateral substantia nigra (SN) in TD and PIGD groups was 79% (sensitivity 76.5%, specificity 78.6%). NM concentration in PD patients decreases gradually during disease progression and differs significantly between PD subtypes. NM may be a reliable biomarker for PD severity and subtype identification.<\/jats:p>","DOI":"10.1007\/s00702-020-02295-8","type":"journal-article","created":{"date-parts":[[2021,2,10]],"date-time":"2021-02-10T02:40:40Z","timestamp":1612924840000},"page":"171-179","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Substantia nigra neuromelanin magnetic resonance imaging in patients with different subtypes of Parkinson disease"],"prefix":"10.1007","volume":"128","author":[{"given":"Lu","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yayun","family":"Yan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liyao","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruirui","family":"Luo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5383-5536","authenticated-orcid":false,"given":"Ying","family":"Chang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,2,9]]},"reference":[{"issue":"3","key":"2295_CR1","doi-asserted-by":"publisher","first-page":"387","DOI":"10.1001\/archneur.60.3.387","volume":"60","author":"D Aarsland","year":"2003","unstructured":"Aarsland D, Andersen K, Larsen JP et al (2003) Prevalence and characteristics of dementia in Parkinson disease:an 8-year prospective study. 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