Parkinson's disease progression in the substantia nigra: location, location, location

Abstract

This scientific commentary refers to ‘Spatiotemporal changes in substantia nigra neuromelanin content in Parkinson’s disease’, by Biondetti et al. (doi:10.1093/brain/awaa216

Figure 1

Historical evidence for location-specific changes in substantia nigra in Parkinson's disease. (A) Topographical progression of Parkinson’s disease, adapted from Fearnley and Lees (1991). Neuronal loss in ventrolateral (VL), ventromedial (VM), dorsolateral (DL), dorsomedial (DM), and pars lateralis (PL) tiers of the substantia nigra in mild (+), moderate (++), and severe (+++) Parkinson’s disease. The greatest neuronal loss occurs early in the ventrolateral tier with progression towards ventromedial, dorsolateral, dorsomedial, and pars lateralis with greater disease severity. (B) One-year changes in free water in the posterior substantia nigra (SN) for controls and patients with Parkinson’s disease, adapted from Ofori et al. (2015b). (C) Four-year changes in free water in the anterior and posterior substantia nigra in de novo Parkinson’s disease. Free water maps show the spatiotemporal progression over 4 years (Burciu et al., 2017). (D) Longitudinal changes in free water in anterior and posterior substantia nigra in controls and advanced Parkinson’s disease with a 3-year follow-up period, adapted with permission from Guttuso et al. (2018). (E) Neuromelanin 1-year changes in healthy control subjects, early and progressing Parkinson’s disease (PD) showing spatiotemporal posterior-anterior progression within the substantia nigra, adapted from Biondetti et al. (2020).