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We applied subtype and stage inference (SuStaIn) to delineate three PD subtypes after quantifying the dual\u2010phase\n                      <jats:sup>18<\/jats:sup>\n                      F\u2010FP\u2010CIT PET data. We compared the baseline clinical features as well as the longitudinal motor and cognitive outcomes between subtypes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Subtype 1 (n\u2009=\u2009406) initially presented with asymmetric dopamine loss in the posterior putamen, followed by dopaminergic deficits in other striatal subregions and, later, cerebral hypoperfusion. Subtype 2 (n\u2009=\u2009205) exhibited diffuse and symmetric striatal dopamine loss in the early stages, followed by cerebral hypoperfusion in the mid\u2010stages. Subtype 3 (n\u2009=\u200989) initially showed the parieto\u2010occipital hypoperfusion, followed by cerebral hypoperfusion in other cortical areas and striatal dopamine depletion. Subtype 2 had an older age of onset, and subtype 3 had a younger age of onset and a lower prevalence of rapid eye movement sleep behavior disorder. Time\u2010dependent Cox regression models showed that the risk of dementia conversion within a follow\u2010up period of 4\u2009years was higher in subtypes 2 and 3 (hazard ratios 1.772 and 2.802, respectively) than subtype 1, after the confounding effects were adjusted. The risk of developing levodopa\u2010induced dyskinesia and freezing of gait was comparable between subtypes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      The spatiotemporal trajectories of striatal dopamine depletion and cerebral hypoperfusion on dual\u2010phase\n                      <jats:sup>18<\/jats:sup>\n                      F\u2010FP\u2010CIT PET images could serve as a potential progression marker for cognitive decline in early\u2010stage PD. \u00a9 2026 The Author(s).\n                      <jats:italic>Movement Disorders<\/jats:italic>\n                      published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.\n                    <\/jats:p>\n                  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