Peer-Reviewed Publication
NPJ Parkinsons Dis2026;12(1)September 12, 2026Letter

Reply to 'The method matters: free water imaging in Parkinson's disease is not a binary verdict'.

Yun Hwa Roh1,2, Jinyoung Youn3,4, Sang-Young Kim5, Hwan Heo6, Soohwa Song6, Beomseok Sohn7
1Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.
2Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
3Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
4Neuroscience Center, Samsung Medical Center, Seoul, Republic of Korea.
5MR Clinical Science, Philips Healthcare, Seoul, Republic of Korea.
6Heuron Co., Ltd., Seoul, Republic of Korea.
7Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. beomseoksohn@gmail.com.

Abstract

We reply to the Matters Arising on our study comparing neuromelanin and free water imaging for early Parkinson's disease diagnosis. The authors raised considerations regarding image registration, age imbalance, repetition time, and conceptual framing. We clarify that our registration pipeline is validated for subcortical structures, that age does not account for neuromelanin's superior performance…

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