{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T05:46:29Z","timestamp":1782279989180,"version":"3.54.5"},"reference-count":54,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T00:00:00Z","timestamp":1782259200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Rapid eye movement sleep behavior disorder (RBD) and visual hallucinations (VH) are prognostically relevant non-motor symptoms in Parkinson\u2019s disease (PD), but their combined effects on local brain dysfunction remain unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To characterize regional brain dysfunction patterns associated with RBD and VH in PD and to explore candidate-region symptom-related effects within regions showing overall between-group differences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this cross-sectional study, 96 patients with PD were divided into four groups according to the presence or absence of RBD and VH (24 per group). Resting-state functional MRI was analyzed using amplitude of low-frequency fluctuations (ALFF) and regional homogeneity (ReHo). Whole-brain four-group analyses were first used to identify regions with overall between-group differences, followed by exploratory ROI-based 2\u202f\u00d7\u202f2 factorial analyses within candidate regions. Additional whole-brain voxel-wise 2\u202f\u00d7\u202f2 factorial analyses were performed as supplementary analyses. Correlations between imaging indices and clinical scales were also examined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Patients with both RBD and VH showed the greatest clinical burden and worse cognitive performance. Whole-brain analyses revealed abnormalities in frontal, temporal, cerebellar, supplementary motor, and precuneus regions. Exploratory candidate-region analyses with Benjamini\u2013Hochberg FDR correction showed RBD-related patterns in precuneus ReHo, cerebellar lobule VIII ReHo, and SMA ALFF; VH-related patterns in OFC ReHo, precuneus ReHo, cerebellar Crus I ReHo, SMA ALFF, and temporal pole ALFF; and interaction-like patterns in OFC ReHo and temporal pole ALFF. These ROI-based findings were interpreted as\n                      <jats:italic>post hoc<\/jats:italic>\n                      exploratory results rather than independent confirmatory evidence. Imaging abnormalities were correlated with RBD severity, freezing of gait, hallucination burden, and cognition.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Coexisting RBD and VH may identify a clinically more severe PD subtype associated with regional abnormalities involving cerebellar, motor, default mode, and association-related regions. Symptom-related main and interaction patterns should be interpreted as candidate-region exploratory findings requiring further confirmation in larger studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2026.1858348","type":"journal-article","created":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T04:49:13Z","timestamp":1782276553000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Regional brain dysfunction patterns associated with rapid eye movement sleep behavior disorder and visual hallucinations in Parkinson\u2019s disease: a resting-state fMRI study with exploratory ROI-based factorial analysis"],"prefix":"10.3389","volume":"17","author":[{"given":"Lifang","family":"She","sequence":"first","affiliation":[{"name":"Department of Geriatrics, The Affiliated Brain Hospital of Nanjing Medical University","place":["Nanjing, 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China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Pan","sequence":"additional","affiliation":[{"name":"Department of Geriatrics, The Affiliated Brain Hospital of Nanjing Medical University","place":["Nanjing, China"]},{"name":"Department of Neurology, Zhongnan Hospital of Wuhan University","place":["Wuhan, Hubei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,24]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"896","DOI":"10.1016\/s0140-6736(14)61393-3","article-title":"Parkinson's disease","volume":"386","author":"Kalia","year":"2015","journal-title":"Lancet"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"399","DOI":"10.1002\/mds.23462","article-title":"The impact of non-motor symptoms on health-related quality of life of patients with Parkinson's disease","volume":"26","author":"Martinez-Martin","year":"2011","journal-title":"Mov 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