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Resting\u2010state functional magnetic resonance imaging (rsfMRI) studies have unveiled altered functional connectivity (rsFC) in patients with iRBD. However, the associations between intra\u2010 and inter\u2010network rsFC with clinical symptoms and neuropsychological functioning in iRBD remain unclear.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To characterize intra\u2010 and inter\u2010network rsFC in iRBD patients using a data\u2010driven approach and to assess its associations with clinical features and cognitive functioning.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Forty\u2010two patients with iRBD and 45 healthy controls (HC) underwent rsfMRI and comprehensive neuropsychological testing. Resting\u2010state networks were characterized using independent component analyses. Group differences in intra\u2010 and inter\u2010network rsFC and their associations with clinical and neuropsychological data were studied. A threshold of corrected <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05 was used in all the analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>iRBD patients displayed lower intra\u2010network rsFC within basal ganglia, visual, sensorimotor, and cerebellar networks, relative to HC. Mean rsFC strength within the basal ganglia network positively correlated with processing speed and negatively with the non\u2010motor symptoms in iRBD patients. Reduced inter\u2010network rsFC between sensorimotor and visual medial networks was observed in iRBD patients, which was associated with global cognitive status.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>iRBD is characterized by both reductions in intra\u2010network rsFC in cortical and subcortical networks and inter\u2010network dysconnectivity between sensorimotor and visual networks. Abnormalities in intra\u2010 and inter\u2010network rsFC are associated with cognitive performance and non\u2010motor symptoms, suggesting the utility of both rsFC measures as imaging markers in prodromal alpha\u2010synucleinopathies. \u00a9 2025 The Author(s). <jats:italic>Movement Disorders<\/jats:italic> published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mds.30126","type":"journal-article","created":{"date-parts":[[2025,1,29]],"date-time":"2025-01-29T02:19:37Z","timestamp":1738117177000},"page":"704-715","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Altered Intra\u2010 and Inter\u2010Network Resting\u2010State Functional Connectivity is Associated with Neuropsychological Functioning and Clinical Symptoms in Patients with Isolated Rapid Eye Movement Sleep Behavior 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