Altered large-scale global brain networks in distinct motor subtypes of Parkinson's disease.

Motivation: The progression and prognosis of Parkinson's disease (PD) vary with different motor subtypes. Goal(s): This study investigated neuroimaging manifestations underlying clinical differences across PD motor subtypes by examining changes in the dynamic balance of large-scale resting-state brain networks. Approach: Resting-state networks were isolated using independent component analysis. We analyzed inter- and intra-network interactions across three groups. Results: Postural instability and gait difficulty-dominant PD displayed more pronounced disruptions in resting-state brain networks relative to tremor-dominant PD, particularly concerning increased imbalance in higher executive cognitive networks interacting with motor networks, where the salience network plays a key regulatory role. Impact: These findings clarify neuroimaging differences across PD motor subtypes, potentially reveal early imaging biomarkers, and offer a new perspective to support clinical diagnosis and treatment.