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We employed co\u2010activation pattern (CAP) analysis to characterize the functional\u2010state alterations in 243 participants using resting\u2010state fMRI data and applied graph theory analysis to estimate corresponding topological properties. The CAP analysis identified five distinct brain states across groups: State 1 (limbic network dominated), State 2 (dorsal attention network (DAN) and central executive network dominated), State 3 (default mode network and central executive network dominated), State 4 (somatomotor network and ventral attention network dominated), and State 5 (DAN, sensorimotor, and visual networks dominated). Compared to cognitively unimpaired individuals, State 3 demonstrated significantly reduced persistence and resilience in both mild cognitive impairment (MCI) and AD groups. Additionally, both clinical groups (MCI and AD) exhibited decreased transitions from State 2 to State 5 and reduced self\u2010transitions within State 3. Graph theory analysis revealed that compared to cognitively unimpaired individuals, MCI and AD individuals had increased node degree centrality and node efficiency, alongside decreased node local efficiency in regions within the default mode network (DAN) and visual network, which corresponded well with CAP analysis results. Our findings provide a multiscale framework linking dynamic state instability to static network reorganization, advancing understanding of the dynamic functional alterations underlying cognitive decline in AD spectrum disorders.<\/jats:p>","DOI":"10.1002\/hbm.70509","type":"journal-article","created":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T05:06:57Z","timestamp":1774588017000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Dynamic Alterations of Functional Systems in Alzheimer's Disease: A Co\u2010Activation Pattern Analysis"],"prefix":"10.1002","volume":"47","author":[{"given":"Pan","family":"Wang","sequence":"first","affiliation":[{"name":"The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, Center for Information in Medicine, School of Life Science and Technology University of Electronic Science and Technology of China  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengfan","family":"Xue","sequence":"additional","affiliation":[{"name":"The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, Center for Information in Medicine, School of Life Science and Technology University of Electronic Science and Technology of China  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingyin","family":"Mao","sequence":"additional","affiliation":[{"name":"The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, Center for Information in Medicine, School of Life Science and Technology University of Electronic Science and Technology of China  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunyan","family":"Wang","sequence":"additional","affiliation":[{"name":"The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, Center for Information in Medicine, School of Life Science and Technology University of Electronic Science and Technology of China  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xing","family":"Yao","sequence":"additional","affiliation":[{"name":"The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, Center for Information in Medicine, School of Life Science and Technology University of Electronic Science and Technology of China  Chengdu China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3710-3500","authenticated-orcid":false,"given":"Bharat B.","family":"Biswal","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering New Jersey Institute of Technology  Newark New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,26]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1021\/bi5009326"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41398\u2010023\u201002722\u2010w"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102796.2004.01386.x"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1113\/JP287099"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600\u20100447.2002.01417.x"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2020.116814"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1196\/annals.1440.011"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1523\/JNEUROSCI.5062\u201008.2009"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrn2575"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-clinpsy-040510-143934"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrn755"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.0601417103"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jalz.2019.05.004"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.0135058100"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12264\u2010024\u201001218\u2010x"},{"key":"e_1_2_11_17_1","doi-asserted-by":"crossref","unstructured":"LaMontagne P. 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