Brain functional alterations in patients with newly diagnosed Parkinson's disease

This PhD thesis examines the impact of early cerebellar and cortical functional changes in newly diagnosed Parkinson's disease (PD) patients, focusing on their potential to predict and influence disease pathology and cognitive outcomes. The research comprises two separate studies, performed on the same cohort of patients using advanced neuroimaging techniques. The first study investigates early cerebellar structural and functional alterations, challenging the traditional view of the cerebellum's compensatory role in PD by highlighting its substantial contribution to both motor and non-motor symptoms from the disease's onset. The second study explores how baseline functional connectivity (FC) changes in key cortical areas associated with ognitive functions - specifically, the dorsolateral prefrontal cortex and the precuneus - can serve as early indicators of cognitive decline. This study not only assesses the predictive value of these FC changes for cognitive impairments but also evaluates their potential as biomarkers for identifying high-risk patients. This thesis underscores the importance of early detection and targeted intervention in PD, aiming to improve patient outcomes through a better understanding of the disease's underlying neurobiological mechanisms