Striosomes and matrix are two compartments that comprise the striatum, each having its own distinct immunohistochemical properties, function, and connectivity. It is currently not clear whether prodromal or early manifest Parkinson’s disease (PD) is associated with any striatal matrix or striosomal abnormality. Recently, a method of striatal parcellation using probabilistic tractography has been described and validated, using the distinct connectivity of these two compartments to identify voxels with striosome- and matrix-like connectivity. The goal of this study was to use this approach in tandem with DAT-SPECT, a method used to quantify the level of nigrostriatal denervation, to analyze the striatum in populations of de novo diagnosed, treatment-naïve patients with PD, isolated REM behavioral disorder (iRBD) patients, and healthy controls. We discovered a shift in striatal connectivity, which showed correlation with nigrostriatal denervation. Patients with PD exhibited a significantly higher matrix-like volume and associated connectivity than healthy controls and higher matrix-associated connectivity than iRBD patients. In contrast, the side with less pronounced nigrostriatal denervation in PD and iRBD patients showed a decrease in striosome-like volume and associated connectivity indices. These findings could point to a compensatory neuroplastic mechanism in the context of nigrostriatal denervation and open a new avenue in the investigation of the pathophysiology of Parkinson’s disease.

纹状体和基质是构成纹状体的两个区室，每个区室都有其独特的免疫组织化学特性、功能和连接性。目前尚不清楚前驱或早期表现的帕金森病 (PD) 是否与任何纹状体基质或纹状体异常相关。最近，已经描述并验证了一种使用概率纤维束成像的纹状体分割方法，利用这两个区室的不同连接性来识别具有纹状体和类矩阵连接性的体素。本研究的目的是将这种方法与 DAT-SPECT（一种用于量化黑质纹状体去神经水平的方法）结合使用，以分析新诊断的、未经治疗的 PD、孤立性 REM 行为障碍患者群体的纹状体(iRBD) 患者和健康对照。我们发现纹状体连接性发生了变化，这表明与黑质纹状体去神经支配相关。与健康对照相比，PD 患者表现出显着更高的类基质体积和相关连接性，并且比 iRBD 患者表现出更高的基质相关连接性。相比之下，PD 和 iRBD 患者黑质纹状体去神经不太明显的一侧显示出纹状体样体积和相关连接指数的减少。这些发现可能指出黑质纹状体去神经背景下的代偿性神经可塑性机制，并为帕金森病病理生理学的研究开辟新途径。