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This multisystem contribution also underlies highly heterogeneous progression rate to dementia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Nondemented PD patients who underwent [<jats:sup>123<\/jats:sup>I]N\u2010\u03c9\u2010fluoropropyl\u20102\u03b2\u2010carbomethoxy\u20103\u03b2\u2010(4\u2010iodophenyl) nortropane ([<jats:sup>123<\/jats:sup>I]FP\u2010CIT) SPECT and neuropsychological examinations were enrolled. Patients who agreed to participate and age\u2010 and sex\u2010matched healthy controls (HCs) also underwent 7\u2010T MRI. Patients were classified as cognitively normal (PD\u2010CN) or mild cognitive impairment (PD\u2010MCI) following the level II criteria of Movement Disorder Society Guideline.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 155 patients (PD\u2010CN\/PD\u2010MCI 74\/81) were enrolled, whereas 76 patients (PD\u2010CN\/PD\u2010MCI 35\/41) and 56 HCs underwent 7\u2009T\u2010MRI. The caudate [<jats:sup>123<\/jats:sup>I]FP\u2010CIT uptake in PD was correlated with the performance of attention\/working memory (trail\u2010making test [TMT]\u2010A and symbol digit modality test) and executive (TMT\u2010B) domains. In contrast, the regional cortical thickness in the left frontotemporal and right frontal lobes in PD was correlated with performance of memory (Hopkins verbal learning test\u2010revised delayed recall) and visuospatial (judgment of line orientation) domains. Moreover, compared to 37 HCs with a Montreal Cognitive Assessment score of &gt;25, PD\u2010CN patients showed broad occipitoparietal cortical thinning.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We demonstrated distinctive impairments of dopaminergic frontostriatal deficits and cortical degeneration as neural bases for the dual\u2010syndrome hypothesis. Our findings suggest that occipitoparietal lobe thinning occurs at a cognitively normal stage, and additional frontotemporal lobe thinning underlies impairments in the memory and visuospatial domains at the PD\u2010MCI stage.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.70022","type":"journal-article","created":{"date-parts":[[2024,12,24]],"date-time":"2024-12-24T08:16:02Z","timestamp":1735028162000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Neural substrates underlying distinct dual cognitive syndromes in Parkinson's disease"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5033-3346","authenticated-orcid":false,"given":"Kenji","family":"Yoshimura","sequence":"first","affiliation":[{"name":"Department of Neurology Kyoto University Graduate School of Medicine  Kyoto 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