| Summary: | <b>Background</b>: To investigate the relationship between fat content and the cross-sectional area of psoas and thigh muscles, and clinical severity in patients with Parkinson’s disease. <b>Materials and Methods</b>: Twenty-five patients and 20 age- and sex-matched normal controls were recruited. All subjects underwent MRI study to determine the fat content of the bilateral psoas and thigh muscles. Muscle quality was measured by grasp, walking speed, and cross-sectional area. All patients underwent clinical surveys to evaluate disease severity and frailty, and analyses of the correlations between muscle quality and disease severity were performed. <b>Results</b>: Compared with the controls, patients exhibited higher fatty content in the measured muscles. The higher fat infiltration of measured muscles was significantly correlated with increased disease severity and frailty in patients. The fat fraction of the bilateral medial compartment of the thigh was correlated with the Unified Parkinson Disease Rating Scale-I results and the fat fraction of the bilateral anterior compartment of the thigh was correlated with weakness and exhaustion in patients. <b>Conclusions</b>: Decreased quality in psoas and thigh muscles is prominent in Parkinson’s disease which is further associated with disease severity and frailty. Awareness of the risk of sarcopenia and associated sequelae might improve patient care and outcomes.
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