ORIGINAL RESEARCH article
Front. Aging Neurosci.
Sec. Parkinson’s Disease and Aging-related Movement Disorders
Altered Attention and Visuospatial Abnormalities in Parkinson's Disease: Links to Attention Networks and Basal Ganglia
Jian Song
Yanyan Li
Yuqing Zhao
Haoping Gu
Jinfeng Xu
Xianling Xu
Wei Wei
Xiehua Xue
Fujian University of Traditional Chinese Medicine, Fuzhou, China
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Abstract
Background: Attentional and visuospatial deficits in Parkinson's disease (PD) are linked to disrupted attention networks (AN), yet specific neural mechanisms remain unclear. This study aims to elucidate the relationship between these dysfunctions and aberrant AN circuits in PD. Methods: Sixty-two PD patients stratified by cognitive status (cognitively normal [PDCN], mild cognitive impairment [PDMCI], and dementia [PDD]) and 53 matched healthy controls (HC) underwent resting state functional MRI. We performed amplitude of low-frequency fluctuation (ALFF) and seed-based functional connectivity (FC) analyses. Relationships with cognitive functions were evaluated via partial correlation and mediation models. A support vector machine (SVM) classifier incorporating AN features was established for diagnostic validation. Results: Compared to HCs, PD patients showed increased ALFF in the right caudate nucleus (CAU) and left insular cortex (Ins), but reduced ALFF in the left middle occipital gyrus (MOG). FC analysis revealed decreased coupling in the right CAU-left cerebellum VI (CVI), left Ins-left middle cingulate gyrus (MCG), and left Ins-right superior temporal gyrus (STG), alongside enhanced left MOG-left inferior parietal lobule (IPL) connectivity. These alterations correlated significantly with cognitive performance. Mediation analysis identified left Ins ALFF and left Ins-left MCG FC as independent mediators of impairments. The SVM classifier achieved 92.2% accuracy (AUC=0.944). Subgroup comparisons revealed increased ALFF in the left triangular inferior frontal gyrus (IFGtri) and angular gyrus (AG) in PDMCI versus PDCN. PDD patients displayed decreased left supramarginal gyrus (SMG) ALFF compared to PDCN. Notably, left SMG-related alterations distinguished PDMCI from PDD and correlated with attention deficits. Conclusion: PD-related attention and visuospatial dysfunctions are closely linked to AN abnormalities. The Ins serves as a key regulatory node, while the SMG emerges as a potential neuroimaging marker for tracking cognitive decline from PDMCI to PDD.
Summary
Keywords
Amplitude of low-frequency fluctuations, Attention function, functional connectivity, Parkinson's disease, resting-state functional magnetic resonance imaging
Received
26 November 2025
Accepted
28 January 2026
Copyright
© 2026 Song, Li, Zhao, Gu, Xu, Xu, Wei and Xue. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Xiehua Xue
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