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The final sample included 771 subjects, comprising 423 patients with PD, 144 with iRBD, and 204 healthy controls. stDNN model was applied to mean timeseries extracted for each subject from rs-fMRI data. By integrating spatio-temporal features, the network classified subjects based on distinct neural patterns. Model generalizability was assessed using subject-wise k-fold cross-validation. Explainable artificial intelligence (XAI) methods were applied. stDNN achieved balanced accuracy rates of 71.0% in distinguishing controls from PD and up to 71.9% in middle-stage PD cases. It also demonstrated over 80% accuracy in differentiating healthy controls from iRBD. XAI analysis highlighted the involvement of fronto-parietal and temporal regions, including the dorsolateral prefrontal cortex, and anterior temporal gyri, in distinguishing controls from PD. In the comparison with iRBD, key contributing areas included the bilateral superior and medial frontal gyri, dorsolateral prefrontal cortex, parietal and occipital regions (lingual gyri and cuneus). This study demonstrates the potential of stDNN to differentiate between iRBD, PD, and controls using rs-fMRI data.<\/jats:p>","DOI":"10.1038\/s41531-026-01477-7","type":"journal-article","created":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T02:36:44Z","timestamp":1783996604000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Spatiotemporal deep learning for early detection of isolated REM sleep behavior disorder and Parkinson\u2019s disease using functional MRI data"],"prefix":"10.1038","volume":"12","author":[{"given":"Silvia","family":"Basaia","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Pisano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabetta","family":"Sarasso","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tania","family":"Filaferro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Gardoni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Marelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta","family":"Balestrino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tommaso","family":"Cusolito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Castelnuovo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Grassi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigi","family":"Ferini-Strambi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosita","family":"De Micco","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Tessitore","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"Salvi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filippo","family":"Molinari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"Agosta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"Filippi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,14]]},"reference":[{"key":"1477_CR1","doi-asserted-by":"publisher","first-page":"e89741","DOI":"10.1371\/journal.pone.0089741","volume":"9","author":"A Iranzo","year":"2014","unstructured":"Iranzo, A. et al. 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S.P., T.F., A.Ga., T.C., A.C., A.Gr., R.DM.,A.T., M.S. and F.M. declare no competing financial or non-financial interests. L.F.-S. is field editor of the journal Sleep Medicine journal, associate editor of the Journal of Alzheimer\u2019s Disease, and member of the editorial board of the European Journal of Neurology, and Behavioral Neurology; L.F.-S. has received speaker honoraria from Biprojet, Idorsia, Italfarmaco, and Takeda, and receives or has received research support from the Italian Ministry of Health and the Italian Ministry of University and Research. F.A. is associate editor of NeuroImage: Clinical; has received speaker honoraria from Biogen Idec, Italfarmaco, Roche, Zambon, and Ely Lilli; and receives or has received research support from the Italian Ministry of Health, the Italian Ministry of University and Research, AriSLA (Fondazione Italiana di Ricerca per la SLA), the European Research Council, the EU Joint Programme\u2014Neurodegenerative Disease Research (JPND), and the Foundation Research on Alzheimer Disease (France). M.F. is editor in chief of the Journal of Neurology and associate editor of Human Brain Mapping, Neurological Sciences, and Radiology; received compensation for consulting services from Almirall, Biogen, Bristol-Myers Squibb, Eli Lilly, Merck, Novartis, Roche, Sanofi; speaking activities from Amgen, Bayer, Biogen, Bristol-Myers Squibb, Celgene, Chiesi Italia SpA, Eisai, Eli Lilly, Fujirebio, Genzyme, Janssen, Merck, Neopharmed Gentili, Neuraxpharm, Novartis, Novo Nordisk, Roche, Sanofi, Takeda; participation in Advisory Boards for Alexion, Biogen, Bristol-Myers Squibb, Eli Lilly, GE Healthcare Ltd, Merck, Neuraxpharm, Novartis, Roche, Sandoz, Sanofi, Takeda; scientific direction of educational events for Biogen, Merck, Roche, Celgene, Bristol-Myers Squibb, Lilly, Novartis, Sanofi-Genzyme; he receives research support from Biogen Idec, Merck-Serono, Novartis, Roche, the Italian Ministry of Health, the Italian Ministry of University and Research, and Fondazione Italiana Sclerosi Multipla.","order":1,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Ethics"}}],"article-number":"273"}}