Midbrain Energy Homeostasis Biomarker for Differential Diagnosis of Early-Stage Parkinson Disease: A 1 H and 31 P MRI Study

Disrupted midbrain energy homeostasis, derived from phosphorus 31 ( 31 P) MR spectroscopy, effectively differentiated early-stage Parkinson disease from its mimics, outperforming conventional hydrogen 1 MRI markers for iron and neuromelanin, establishing 31 P MR spectroscopy as a promising diagnostic tool.