Striatal representations and network correlates of digital motor scores in Parkinsons disease
- 1University of Tuebingen
Abstract
Digital health technology (DHT) enables to detect and quantify charateristics motor dysfunction in Parkinsons disease (PD). However, the understanding of the relationship between dopaminergic nigrostriatal denervation and quantitative composite digital motor scores (DMS) captured by DHT remains largely limited to date.
In this hybrid PET-MRI study, we used simultaneously acquired PET with 11C-d-threo-methylphenidate (11C-dMP-PET) - a tracer of presynaptic dopamine transporters - and resting-state-fMRI (rs-fMRI) to investigate this relationship and to explore associated neural network correlates in PD.
Seventeen PD patients and 39 healthy controls underwent 11C-dMP-PET and rs-fMRI. Quantitative composite DMS for arm swing, gait and balance were calculated using DHT-derived parameters. Voxel-based correlation analysis of 11C-dMP-PET binding potential (BPNP) was performed for each DMS and resulting clusters were used for seed-based functional connectivity analyses.
We found that DMS of arm swing, gait and balance exhibit differential striatal representations associated with dopaminergic denervation as assessed by 11C-dMP-PET. Specifically, lower BPNP correlated with higher (i. e. more pathologic) arm swing DMS in the central putamen and higher balance DMS in the right caudate, whereas the most robust correlation was observed for lower BPND with higher gait DMS in the right caudate and anteromedial putamen. Seed-based functional connectivity analysis revealed lower functional connectivity in a frontostriatal network encompassing the basal ganglia and medial frontal regions associated to pathological gait DMS in PD.
Taken together, our study demonstrates striatal representations of key domains of PD motor dysfunction captured by DHT. Highlighting the complex interplay of gait motor control, we show that gait dysfunction is associated with dopaminergic denervation in the anteromedial executive subregion of the striatum and frontostriatal connectivity changes in regions involved in planning and initiation of movement sequences. Therefore, our study provides first preliminary insights into the relationship of dopaminergic degeneration and DMS encouraging further investigation in larger cohorts and longitudinal studies to construct and validate digital motor biomarkers obtained from DHT as outcome measures in clinical trials in PD.
Abbreviated summaryUsing 11C-d-threo-methylphenidate-PET and resting-state-fMRI, Roeben et al. investigate the relationship between dopaminergic denervation and digital motor scores (DMS) in Parkinsons disease. They show that gait DMS are associated with dopaminergic denervation in the anteromedial executive striatum and frontostriatal connectivity changes in regions involved in planning and initiation of movement sequences.
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BibTeX
@misc{roeben2026striatal,
title = {{Striatal representations and network correlates of digital motor scores in Parkinsons disease}},
author = {B. Roeben and D. Blum and B. Gallardo Montes and T. M. Ionescu and C. Hansen and I. Wurster and A.-K. von Thaler and K. Herfert and B. Bender and G. W. Eschweiler and T. Gasser and K. Brockmann and D. Berg and W. Maetzler and C. la Fougere and M. Reimold},
howpublished = {medRxiv},
year = {2026},
month = sep,
doi = {10.64898/2026.09.27.26364116},
url = {https://www.medrxiv.org/content/10.64898/2026.09.27.26364116v1},
note = {CC BY-NC-ND},
}
RIS
TY - UNPB
TI - Striatal representations and network correlates of digital motor scores in Parkinsons disease
AU - B. Roeben
AU - D. Blum
AU - B. Gallardo Montes
AU - T. M. Ionescu
AU - C. Hansen
AU - I. Wurster
AU - A.-K. von Thaler
AU - K. Herfert
AU - B. Bender
AU - G. W. Eschweiler
AU - T. Gasser
AU - K. Brockmann
AU - D. Berg
AU - W. Maetzler
AU - C. la Fougere
AU - M. Reimold
PY - 2026
DA - 2026/09/27
PB - medRxiv
DO - 10.64898/2026.09.27.26364116
UR - https://www.medrxiv.org/content/10.64898/2026.09.27.26364116v1
AB - Digital health technology (DHT) enables to detect and quantify charateristics motor dysfunction in Parkinsons disease (PD). However, the understanding of the relationship between dopaminergic nigrostriatal denervation and quantitative composite digital motor scores (DMS) captured by DHT remains largely limited to date. In this hybrid PET-MRI study, we used simultaneously acquired PET with 11C-d-threo-methylphenidate (11C-dMP-PET) - a tracer of presynaptic dopamine transporters - and resting-state-fMRI (rs-fMRI) to investigate this relationship and to explore associated neural network correlates in PD. Seventeen PD patients and 39 healthy controls underwent 11C-dMP-PET and rs-fMRI. Quantitative composite DMS for arm swing, gait and balance were calculated using DHT-derived parameters. Voxel-based correlation analysis of 11C-dMP-PET binding potential (BPNP) was performed for each DMS and resulting clusters were used for seed-based functional connectivity analyses. We found that DMS of arm swing, gait and balance exhibit differential striatal representations associated with dopaminergic denervation as assessed by 11C-dMP-PET. Specifically, lower BPNP correlated with higher (i. e. more pathologic) arm swing DMS in the central putamen and higher balance DMS in the right caudate, whereas the most robust correlation was observed for lower BPND with higher gait DMS in the right caudate and anteromedial putamen. Seed-based functional connectivity analysis revealed lower functional connectivity in a frontostriatal network encompassing the basal ganglia and medial frontal regions associated to pathological gait DMS in PD. Taken together, our study demonstrates striatal representations of key domains of PD motor dysfunction captured by DHT. Highlighting the complex interplay of gait motor control, we show that gait dysfunction is associated with dopaminergic denervation in the anteromedial executive subregion of the striatum and frontostriatal connectivity changes in regions involved in planning and initiation of movement sequences. Therefore, our study provides first preliminary insights into the relationship of dopaminergic degeneration and DMS encouraging further investigation in larger cohorts and longitudinal studies to construct and validate digital motor biomarkers obtained from DHT as outcome measures in clinical trials in PD. Abbreviated summaryUsing 11C-d-threo-methylphenidate-PET and resting-state-fMRI, Roeben et al. investigate the relationship between dopaminergic denervation and digital motor scores (DMS) in Parkinsons disease. They show that gait DMS are associated with dopaminergic denervation in the anteromedial executive striatum and frontostriatal connectivity changes in regions involved in planning and initiation of movement sequences.
ER -