Objective　Cerebrospinal　fluid　(CSF)　biomarkers,　such　as　alpha-synuclein　(alpha-syn),　amyloid　beta　peptide　1-42　(A　beta(1-42)),　phosphorylated　tau　(181P)　(p-tau),　and　total　tau　(t-tau),　have　long　been　associated　with　the　development　of　Parkinson　disease　(PD)　and　other　neurodegenerative　diseases.　In　this　investigation,　we　reported　the　assessment　of　CSF　biomarkers　and　their　correlations　with　vesicular　monoamine　transporter　2　(VMAT2)　bindings　measured　with　F-18-9-fluoropropyl-(+)-dihydrotetrabenazine　(F-18-AV133)　that　is　being　developed　as　a　bio-marker　for　PD.　We　test　the　hypothesis　that　monoaminergic　degeneration　was　correlated　with　CSF　biomarker　levels　in　untreated　PD　patients.　Methods　The　available　online　data　from　the　Parkinson＇s　Progression　Markers　Initiative　study　(PPMI)　project　were　collected　and　analyzed,　which　include　demographic　information,　clinical　evaluations,　CSF　biomarkers　(alpha-syn,　A　beta　1-42,　p-tau,　and　t-tau),　F-18-AV133　brain　PET,　and　T1　weighted　MRIs.　Region　of　interest　(ROI)　and　voxel-wise　Pearson　correlation　between　standardized　uptake　value　ratio　(SUVR)　and　CSF　biomarkers　were　calculated.　Results　Our　major　findings　are:　1)　Compared　with　controls,　CSF　alpha-syn　and　tau　levels　decreased　significantly　in　PD;　2)　alpha-syn　was　closely　correlated　with　A　beta(1-42)　and　tau　in　PD,　especially　in　early-onset　patients;　and　3)　hypothesis-driven　ROI　analysis　found　a　significant　negative　correlation　between　CSF　A　beta(1-42)　levels　and　VMAT2　densities　in　post　cingulate,　left　caudate,left　anterior　putamen,　and　left　ventral　striatum　in　PDs.　CSF　t-tau　and　p-tau　levels　were　significantly　negatively　related　to　VMAT2　SUVRs　in　substantia　nigra　and　left　ventral　striatum,　respectively.　Voxel-wise　analysis　showed　that　left　caudate,　parahippocampal　gyrus,　insula　and　temporal　lobe　were　negatively　correlated　with　A　beta(1-42).　In　addition,　superior　frontal　gyrus　and　transverse　temporal　gyrus　were　negatively　correlated　with　CSF　p-tau　levels.　Conclusion　These　results　suggest　that　monoaminergic　degeneration　in　PD　is　correlated　with　CSF　biomarkers　associated　with　cognitive　impairment　in　neurodegenerative　diseases　including　Alzheimer＇s　disease.　The　association　between　loss　of　dopamine　synaptic　function　and　pathologic　protein　accumulations　in　PD　indicates　an　important　role　of　CSF　biomarkers　in　PD　development.