Sleep benefit in patients with Parkinson’s disease is associated with the dopamine transporter expression in putamen

•The sleep benefit (SB) phenomenon was identified in PD patients and associated with sleep quality in PD patients.•SB variable was associated with the putamen 11C-CFT uptake index after correction for important clinical confounders. This provides evidence that SB phenomenon might be associated with dopamine terminal function and intracellular dopamine storage capacity in PD patients.•The putamen 11C-CFT uptake index has high capacity in predicting the SB in PD patients, and it is meaningful in discerning those PD patients with SB phenomenon who might be alleviated by improving the sleep quality instead of increasing the medication dose. Sleep benefit (SB) is a well-known phenomenon in patients with Parkinson’s disease (PD); however, the mechanisms underlying this phenomenon remain unclear. This study aimed to evaluate whether the SB phenomenon in PD patients is associated with dopamine transporter (DAT) expression levels in the striatum. The data of 125 PD patients were collected and divided into SB (n = 61) and non-SB (nSB) groups (n = 54) depending on whether they had SB or not. DAT expression on both sides of the striatum in PD patients was measured using 2b-carbomethoxy-3b-(4-trimethylstannylphenyl) tropane (11C-CFT) positron emission tomography imaging. The clinical variables, sleep scores, and striatum 11C-CFT uptake index of PD patients between the SB and nSB groups were compared. The associations of clinical variables, sleep scores, and striatum 11C-CFT uptake index with the SB variable were analyzed using logistic regression analysis. A receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value of the striatum 11C-CFT uptake index in distinguishing SB patients from nSB patients. The tremor subtype ratio (P = 0.011), levodopa equivalent daily dose (LEDD) (P