Changes to voxel-wise spontaneous activity and linked brain functional networks in PD patients with distinct motor subtypes.

Motivation: Clinical symptoms vary among motor subtypes of Parkinson's disease (PD). Goal(s): This study investigated brain functional differentiation and integration abnormalities across PD motor subtypes. Approach: We used degree centrality (DC) and seed-based functional connectivity (FC) analyses, as well as voxel based morphometry (VBM) to explore neuroimaging manifestations associated with different PD motor subtypes. Results: Postural instability and gait difficulty-dominant PD (PD-PIGD) patients showed reduced DC in the right superior frontal gyrus. Secondary FC alterations and gray matter volume atrophy also were more pronounced in PD-PIGD than in tremor-dominant PD. Impact: These findings suggest that PD-PIGD represents a more severe PD subtype, offering new insights into clinical differences between PD motor subtypes.