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We investigated sex-specific alterations in speech and striato-cortical networks in 104 patients with early PD\u00a0(68M\/36F), and 44 healthy controls (23M\/21F), using quantitative speech markers and multimodal neuroimaging. Speech features related to prosody, phonation, articulation, fluency, and rhythm, were extracted from voice recordings; striatal dopaminergic loss was quantified using DaT-SPECT, and functional connectivity between striatal and cortical language networks was analyzed with resting-state fMRI. Results showed that PD-related speech impairments were more pronounced in males. Functional connectivity was globally reduced in PD, but female patients exhibited higher caudate-cortical connectivity. In males, speech deficits were associated with both dopaminergic loss and connectivity disruption, whereas in females, only connectivity changes were involved. These findings revealed sex-specific pathophysiological mechanisms in early PD speech disorders, emphasizing the need for sex-stratified approaches in research and clinical practice.<\/jats:p>","DOI":"10.1038\/s41531-026-01509-2","type":"journal-article","created":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T16:32:20Z","timestamp":1791822740000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Striatal network dysfunction underlying speech impairment in early Parkinson\u2019s disease"],"prefix":"10.1038","volume":"12","author":[{"given":"Caitlin Paige","family":"Rogers","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandy","family":"Mournet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u00e9cile","family":"Gallea","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma","family":"Biondetti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graziella","family":"Mangone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Sambin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lydia","family":"Chougar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Villain","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rahul","family":"Gaurav","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabelle","family":"Arnulf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie-Odile","family":"Habert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dijana","family":"Petrovska-Delacre\u0301taz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Christophe","family":"Corvol","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Habib","family":"Benali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Vidailhet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"St\u00e9phane","family":"Lehe\u0301ricy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9202-5165","authenticated-orcid":false,"given":"Laetitia","family":"Jeancolas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,10,12]]},"reference":[{"key":"1509_CR1","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1044\/jshr.1202.246","volume":"12","author":"Frederic L Darley","year":"1969","unstructured":"Darley, F. 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