Abstract
Patients with Parkinson’s disease (PD) frequently present autonomic cardiovascular dysfunction. This study investigated the involvement of autonomic centers in the upper thoracic spinal cord in cardiovascular dysfunction in patients with PD using multimodal MRI and markers of orthostatic hypotension. We recruited 26 patients with PD, stratified based on the presence (PDRBD(+), n = 11) or absence (PDRBD(−), n = 15) of rapid-eye movement sleep behavior disorder (RBD), and 22 matched healthy controls (HC). Participants underwent multimodal MRI of the cervical and upper thoracic spinal cord. Quantitative metrics, including T1 relaxation times, diffusion metrics, and magnetization transfer ratio (MTR) values, were extracted from gray and white matter spinal cord regions. MRI metrics were compared across groups and examined for associations with blood pressure drops, both cross-sectionally and longitudinally, as indicators of orthostatic hypotension. No significant differences in MRI metrics were found between patients with PD and HCs, nor between PD subgroups. A multivariate analysis pooling all MRI metrics together allowed for the separation of HCs and PD subgroups. In the PDRBD(+) subgroup, positive correlations were found between systolic blood pressure drop and T1 relaxation times as well as mean diffusivity values at the cervicothoracic junction. Longitudinal changes in blood pressure drops were associated with MRI measurements after adjusting for baseline blood pressure, age, and sex, suggesting that these metrics may serve as potential markers of future blood pressure changes. These preliminary findings suggest that spinal cord quantitative MRI measurements at the cervicothoracic junction may be associated with orthostatic hypotension in PDRBD(+) patients.
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The data obtained in this research are available from the corresponding author upon reasonable request.
Code availability
The codes used for the analyses are available at https://github.com/sct-pipeline/spine-park.
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Acknowledgements
The study was funded by grants from Agence Nationale de la Recherche (ANRMNP 2009, Nucleipark), DHOS-Inserm (2010, Nucleipark), France Parkinson, École des NeuroSciences de Paris (ENP), Fondation pour la Recherche Médicale (FRM), and the Investissements d’Avenir, IAIHU-06 (Paris Institute of Neurosciences – IHU), ANR-11-INBS-0006, Fondation d’Entreprise EDF, Biogen Inc., Fondation Thérèse and René Planiol, Unrestricted support for Research on Parkinson’s disease from Energipole and Société Française de Médecine Esthétique. L.C. received funding from the Société Française de Radiologie (SFR), the Collège des Enseignants en Radiologie de France (CERF), and the Société Française de Neuroradiologie (SFNR). J.V. received funding from the European Union’s Horizon Europe research and innovation program under the Marie Skłodowska-Curie grant (no. 101107932). E.B. received fellowship funding from Association France Parkinson, Biogen Inc., and the European Union’s Horizon Europe research and innovation program under the Marie Skłodowska-Curie Actions (no. 101066055, acronym HERMES).
Funding
The study was funded by grants from Agence Nationale de la Recherche (ANRMNP 2009, Nucleipark), DHOS-Inserm (2010, Nucleipark), France Parkinson, École des NeuroSciences de Paris (ENP), Fondation pour la Recherche Médicale (FRM), and the Investissements d’Avenir, IAIHU-06 (Paris Institute of Neurosciences – IHU), ANR-11-INBS-0006, Fondation d’Entreprise EDF, Biogen Inc., Fondation Thérèse and René Planiol, Unrestricted support for Research on Parkinson’s disease from Energipole and Société Française de Médecine Esthétique. L.C. received funding from the Société Française de Radiologie (SFR), the Collège des Enseignants en Radiologie de France (CERF), and the Société Française de Neuroradiologie (SFNR). J.V. received funding from the European Union’s Horizon Europe research and innovation program under the Marie Skłodowska-Curie grant (no. 101107932). E.B. received fellowship funding from Association France Parkinson, Biogen Inc., and the European Union’s Horizon Europe research and innovation program under the Marie Skłodowska-Curie Actions (no. 101066055, acronym HERMES).
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L.C. designed and conceptualized the study, collected and analyzed the data, drafted the manuscript for intellectual content. F.X.L conceptualized the study, analyzed the data, and revised the manuscript for intellectual content. J.C.A., M.G.P., J.N., J.V., K.W., analyzed the data and revised the manuscript. C.L., J.D., and A.D., helped with the methodology and revised the manuscript for intellectual content. E.B., C.J., N.P., S.S. G.M., J.C.C, I.A. collected the data, and revised the manuscript for intellectual content. M.V. and S.L. designed and conceptualized the study, collected the data, and revised the manuscript for intellectual content.
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Chougar, L., Lejeune, FX., Cohen-Adad, J. et al. Spinal cord involvement and cardiovascular autonomic dysfunction in Parkinson’s disease. Sci Rep (2026). https://doi.org/10.1038/s41598-026-38152-z
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DOI: https://doi.org/10.1038/s41598-026-38152-z
