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The relationship between the two networks in individual patients is unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      To determine whether a consistent relationship exists between these networks, we measured the difference between PDRP and PDCP expression, termed delta, on an individual basis in independent populations of patients with iPD (n\u00a0=\u00a0356), patients with idiopathic REM sleep behavioral disorder (iRBD) (n\u00a0=\u00a021), patients with genotypic PD (gPD) carrying\n                      <jats:italic>GBA1<\/jats:italic>\n                      variants (n\u00a0=\u00a012) or the\n                      <jats:italic>LRRK2<\/jats:italic>\n                      \u2010G2019S mutation (n\u00a0=\u00a014), patients with atypical parkinsonian syndromes (n\u00a0=\u00a0238), and healthy control subjects (n\u00a0=\u00a095) from the United States, Slovenia, India, and South Korea.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We used [\n                      <jats:sup>18<\/jats:sup>\n                      F]\u2010fluorodeoxyglucose positron emission tomography and resting\u2010state fMRI to quantify delta and to compare the measure across samples; changes in delta over time were likewise assessed in longitudinal patient samples. Lastly, we evaluated delta in prodromal individuals with iRBD and subjects with gPD.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Delta was abnormally elevated in each of the four iPD samples (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.05), as well as in the at\u2010risk iRBD group (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.05), with increasing values over time (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001). PDRP predominance was also present in gPD, with higher values in patients with\n                      <jats:italic>GBA1<\/jats:italic>\n                      variants compared with the less aggressive\n                      <jats:italic>LRRK2<\/jats:italic>\n                      \u2010G2019S mutation (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.005). This trend was not observed in patients with atypical parkinsonian syndromes, who were accurately discriminated from iPD based on PDRP expression and delta (area under the curve\u00a0=\u00a00.85;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.0001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>PDRP predominance, quantified by delta, assays the spread of dysfunction from motor to cognitive networks in patients with PD. Delta may therefore aid in differential diagnosis and in tracking disease progression in individual patients. \u00a9 2022 International Parkinson and Movement Disorder Society.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/mds.29188","type":"journal-article","created":{"date-parts":[[2022,8,23]],"date-time":"2022-08-23T09:00:20Z","timestamp":1661245220000},"page":"2247-2256","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Stereotyped Relationship Between Motor and Cognitive Metabolic Networks in Parkinson's Disease"],"prefix":"10.1002","volume":"37","author":[{"given":"Toma\u017e","family":"Rus","sequence":"first","affiliation":[{"name":"Department of Neurology UMC Ljubljana  Ljubljana Slovenia"},{"name":"Medical Faculty University of Ljubljana  Ljubljana 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