Identifying Brain Degeneration Patterns in Early-Stage Parkinson's Disease: A Multimodal MRI Study

Motivation: Parkinson's disease (PD) is characterized by high heterogeneity, and the patterns of brain changes in early-stage remain unclear. Goal(s): This study aimed to identify distinct patterns of brain degeneration among early-stage PD patients and to investigate their clinical relevance. Approach: We assessed cortical morphology, white matter microstructure, and subcortical iron metabolism using multimodal MRI, integrating these data through dimensionality reduction and clustering to identify subtypes. Results: We identified a subtype characterized by an early malignant brain degeneration pattern with pronounced clinical symptoms at baseline, and another subtype with initial neuroadaptive changes, where patients exhibited mild symptoms at baseline but accelerated progression during follow-up. Impact: This classification strategy showed potential stratification capabilities of multimodal MRI at early disease stages, and offered new insights into early neurodegenerative heterogeneities and clinical relevance in PD patients.