{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T18:03:17Z","timestamp":1792000997344,"version":"4.4.0"},"reference-count":92,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T00:00:00Z","timestamp":1776816000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Bioengineering"],"abstract":"<jats:p>Parkinson\u2019s disease (PD) may benefit from non-pharmacological motor\u2013cognitive rehabilitation, but sensitive neuroimaging markers of training-related brain changes remain limited. This study investigated whether 4 weeks of daily Quadrato Motor Training (QMT) modulate resting-state functional connectivity (FC) in PD and secondarily explored whether whole-brain radiomic features derived from T1-weighted and fractional anisotropy (FA) images could detect pre\u2013post differences over this short intervention interval. Fifty patients with idiopathic PD were randomized to QMT or a SHAM repetitive stepping condition, and 48 completed the protocol (25 SHAM, 23 QMT). MRI was acquired at baseline and after 4 weeks and included resting-state fMRI, 3D T1-weighted imaging, and diffusion-derived FA maps. Resting-state fMRI was analyzed using independent component analysis and dual regression, whereas an IBSI-compliant radiomics workflow and machine-learning models were used for exploratory scan-level classification. Compared with baseline, the SHAM group showed reduced synchronization across several resting-state networks, whereas the QMT group showed increased synchronization in the right sensorimotor and frontoparietal networks and no significant reductions. Between-group analyses showed lower delta-FC in SHAM than QMT in the cerebellar and sensorimotor networks. In contrast, radiomics showed limited discrimination between pre- and post-QMT scans; the best model achieved a ROC-AUC of 0.65 with near-chance accuracy, and no selected predictor remained significant after multiple-comparison correction. These findings suggest that QMT may support short-term functional network stability or task-relevant reorganization in PD relative to the SHAM condition, whereas whole-brain structural radiomics appears less sensitive for detecting early training-related effects in this setting.<\/jats:p>","DOI":"10.3390\/bioengineering13050486","type":"journal-article","created":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T12:54:08Z","timestamp":1776862448000},"page":"486","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Quadrato Motor Training in Parkinson\u2019s Disease: Resting-State fMRI Changes and Exploratory Whole-Brain Radiomics"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6823-7707","authenticated-orcid":false,"given":"Carlo Cosimo","family":"Quattrocchi","sequence":"first","affiliation":[{"name":"Centre for Medical Sciences-CISMed, University of Trento, 38122 Trento, Italy"},{"name":"Department of Radiological Sciences and Medical Imaging, Azienda Sanitaria Universitaria Integrata del Trentino (ASUIT) Provincia Autonoma Di Trento, 38123 Trento, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7732-2062","authenticated-orcid":false,"given":"Claudia","family":"Piervincenzi","sequence":"additional","affiliation":[{"name":"Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raffaella","family":"Di Giacopo","sequence":"additional","affiliation":[{"name":"Neurology Unit of Rovereto, Azienda Sanitaria Universitaria Integrata del Trentino (ASUIT) Provincia Autonoma Di Trento, 38123 Trento, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donatella","family":"Ottaviani","sequence":"additional","affiliation":[{"name":"Neurology Unit of Rovereto, Azienda Sanitaria Universitaria Integrata del Trentino (ASUIT) Provincia Autonoma Di Trento, 38123 Trento, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Chiara","family":"Malaguti","sequence":"additional","affiliation":[{"name":"Neurology Unit of Rovereto, Azienda Sanitaria Universitaria Integrata del Trentino (ASUIT) Provincia Autonoma Di Trento, 38123 Trento, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Longo","sequence":"additional","affiliation":[{"name":"Neurology Unit of Rovereto, Azienda Sanitaria Universitaria Integrata del Trentino (ASUIT) Provincia Autonoma Di Trento, 38123 Trento, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Cattoi","sequence":"additional","affiliation":[{"name":"Department of Radiological Sciences and Medical Imaging, Azienda Sanitaria Universitaria Integrata del Trentino (ASUIT) Provincia Autonoma Di Trento, 38123 Trento, 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