{"doi":"10.1002/mds.28838","title":"Diffusion Magnetic Resonance Imaging Detects Progression in <scp>Parkinson's</scp> Disease: A Placebo‐Controlled Trial of Rasagiline","abstract":"BACKGROUND: Rasagiline has received attention as a potential disease-modifying therapy for Parkinson's disease (PD). Whether rasagiline is disease modifying remains in question. OBJECTIVE: The main objective of this study was to determine whether rasagiline has disease-modifying effects in PD over 1 year. Secondarily we evaluated two diffusion magnetic resonance imaging pulse sequences to determine the best sequence to measure disease progression. METHODS: This prospective, randomized, double-blind, placebo-controlled trial assessed the effects of rasagiline administered at 1 mg/day over 12 months in early-stage PD. The primary outcome was 1-year change in free-water accumulation in posterior substantia nigra (pSN) measured using two diffusion magnetic resonance imaging pulse sequences, one with a repetition time (TR) of 2500 ms (short TR; n = 90) and one with a TR of 6400 ms (long TR; n = 75). Secondary clinical outcomes also were assessed. RESULTS: Absolute change in pSN free-water accumulation was not significantly different between groups (short TR: P = 0.346; long TR: P = 0.228). No significant differences were found in any secondary clinical outcomes between groups. Long TR, but not short TR, data show pSN free-water increased significantly over 1 year (P = 0.025). Movement Disorder Society Unified Parkinson's Disease Rating Scale testing of motor function, Part III increased significantly over 1 year (P = 0.009), and baseline free-water in the pSN correlated with the 1-year change in Movement Disorder Society Unified Parkinson's Disease Rating Scale testing of motor function, Part III (P = 0.004) and 1-year change in bradykinesia score (P = 0.044). CONCLUSIONS: We found no evidence that 1 mg/day rasagiline has a disease-modifying effect in PD over 1 year. We found pSN free-water increased over 1 year, and baseline free-water relates to clinical motor progression, demonstrating the importance of diffusion imaging parameters for detecting and predicting PD progression. © 2021 International Parkinson and Movement Disorder Society.","journal":"Movement Disorders","year":2021,"id":179842,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":18,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9665,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":432730,"name":"Trina Mitchell","orcid":"0000-0002-0442-9985","position":1,"is_corresponding":false},{"id":463985,"name":"Derek B. Archer","orcid":"0000-0001-8638-0785","position":2,"is_corresponding":false},{"id":348669,"name":"Roxana G. Burciu","orcid":"0000-0002-0212-4950","position":3,"is_corresponding":false},{"id":432729,"name":"Winston T. Chu","orcid":"0000-0001-7818-9139","position":4,"is_corresponding":false},{"id":728141,"name":"Hanzhi Gao","orcid":null,"position":5,"is_corresponding":false},{"id":397560,"name":"Thomas Guttuso","orcid":"0000-0001-8708-032X","position":6,"is_corresponding":false},{"id":345847,"name":"Christopher W. Hess","orcid":"0000-0002-7317-8999","position":7,"is_corresponding":false},{"id":679688,"name":"Song Lai","orcid":"0000-0002-9582-6790","position":8,"is_corresponding":false},{"id":560280,"name":"Irene A. Malaty","orcid":"0000-0001-6914-9223","position":9,"is_corresponding":false},{"id":348671,"name":"Nikolaus R. McFarland","orcid":"0000-0002-8699-8857","position":10,"is_corresponding":false},{"id":311510,"name":"Ofer Pasternak","orcid":"0000-0002-7078-6446","position":11,"is_corresponding":false},{"id":352830,"name":"Catherine C. Price","orcid":"0000-0001-5994-0644","position":12,"is_corresponding":false},{"id":342088,"name":"Aparna Wagle Shukla","orcid":"0000-0002-9757-9973","position":13,"is_corresponding":false},{"id":277890,"name":"Samuel S. Wu","orcid":"0000-0003-2684-436X","position":14,"is_corresponding":false},{"id":271889,"name":"Michael S. Okun","orcid":"0000-0002-6247-9358","position":15,"is_corresponding":false},{"id":348661,"name":"David E. Vaillancourt","orcid":"0000-0002-5663-6476","position":16,"is_corresponding":false},{"id":520932,"name":"David J. Arpin","orcid":"0000-0002-6442-1205","position":0,"is_corresponding":true}],"reference_count":24,"raw_metadata":null,"created_at":"2026-07-18T23:47:48.974996Z","pmid":"34724257","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}