Background. Brain regions subserving emotion have mostly been studied using functional magnetic resonance imaging (fMRI) during emotion provocation procedures in healthy participants. Objective. To identify neuroanatomical regions associated with spontaneous changes in emotional state over time. Methods. Self-rated emotional valence and arousal scores, and regional cerebral blood flow (rCBF) measured by perfusion MRI, were measured 4 or 8 times spanning at least 2 weeks in each of 21 subjects with Parkinson’s disease (PD). A random-effects SPM analysis, corrected for multiple comparisons, identified significant clusters of contiguous voxels in which rCBF varied with valence or arousal. Results. Emotional valence correlated positively with rCBF in several brain regions, including medial globus pallidus, orbital prefrontal cortex (PFC), and white matter near putamen, thalamus, insula, and medial PFC. Valence correlated negatively with rCBF in striatum, subgenual cingulate cortex, ventrolateral PFC, and precuneus—posterior cingulate cortex (PCC). Arousal correlated positively with rCBF in clusters including claustrum-thalamus-ventral striatum and inferior parietal lobule and correlated negatively in clusters including posterior insula—mediodorsal thalamus and midbrain. Conclusion. This study demonstrates that the temporal stability of perfusion MRI allows within-subject investigations of spontaneous fluctuations in mental state, such as mood, over relatively long-time intervals. 1. Background Even though Parkinson’s disease (PD) is a neurodegenerative disease defined by motor features [1], psychiatric sequelae are common such as depression, anxiety, and apathy [2, 3]. Previous studies have shown alteration of emotional processing in PD including reduced emotional physiologic response [4], impaired emotional word recognition [5], and impaired arousal judgment but normal valence [6]. The bulk of the evidence suggests that these changes result primarily from the degenerative process in the brain, and are not merely psychological reactions to disability [3]. Pathologically, Braak and Del Tredici [7] found that in PD clinical stages 1–3 (stage 4-5 pathologically), neurodegeneration could be seen in almost all areas of the brain including prefrontal cortex (PFC) and limbic system. Brain areas affected by PD that are hypothesized to cause emotional dysfunction including raphe nuclei, locus ceruleus, amygdala, mesolimbic, mesocortical, mesothalamic dopaminergic systems, and cingulate cortex [8]. Furthermore, neuroimaging studies have shown that a decrease in
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