OBJECTIVE: To investigate the relationship of synaptic loss with glucose metabolism and dopaminergic transporters in Parkinson's disease (PD) patients. METHODS: A total of 16 patients with PD and 11 age-matched healthy controls underwent positron emission tomography (PET) with the tracers [ RESULTS: Compared with that in the NC group, the synaptic density in the caudate region was significantly lower in the PD group (SUVR: 2.51 ± 0.36 vs. 3.18 ± 0.32, p <
0.001), especially in the pre-commissural caudate and post-commissural caudate (SUVR: 2.42 ± 0.29 vs. 2.63 ± 0.32, p <
0.01
0.76 ± 0.31 vs. 0.97 ± 0.33, p <
0.001). A reduced synaptic density was significantly correlated with DAT (r = 0.61, p <
0.001) and glucose metabolism (r = 0.73, p <
0.001) in the post-commissural caudate. In the post-commissural regions of the caudate, there was a partial mediating effect of synaptic density on the relationship between glucose metabolism and DAT availability (indirect effect: β CONCLUSION: [