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SuStaIn identified three reproducible subtypes of nigrostriatal dopaminergic degeneration: (S1) left posterior putamen, (S2) right posterior putamen, and (S3) bilateral caudate, with high longitudinal stability. At baseline, S3 patients were older, exhibited greater cognitive and psychiatric burden, and demonstrated lower cerebrospinal fluid \u03b1-synuclein seeding positivity. Longitudinally, motor symptoms improved more in S1 and S2 than in S3 upon initiation of treatment, whereas depression and anxiety worsened preferentially in S2 and impulsive\u2013compulsive behaviours increased in S3. DAT-SPECT-based SuStaIn thus reconstructs biologically plausible dopaminergic progression patterns and yields clinically meaningful subtypes with short-term prognostic relevance.\n                  <\/jats:p>","DOI":"10.1038\/s41531-026-01347-2","type":"journal-article","created":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T10:29:30Z","timestamp":1776248970000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["DAT-SPECT-based subtype and stage inference in Parkinson\u2019s disease"],"prefix":"10.1038","volume":"12","author":[{"given":"Masakazu","family":"Ozawa","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daisuke","family":"Yoshimaru","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ami","family":"Yuzawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenji","family":"Ishii","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirotaka James","family":"Okano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,4,15]]},"reference":[{"key":"1347_CR1","doi-asserted-by":"publisher","first-page":"896","DOI":"10.1016\/S0140-6736(14)61393-3","volume":"386","author":"LV Kalia","year":"2015","unstructured":"Kalia, L. 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