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. 2022 Sep 2;144(5):861–879. doi: 10.1007/s00401-022-02488-3

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© The Author(s) 2022

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

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Fig. 1 — Microstructural changes in the motor system of longitudinally followed iRBD cases that progressed to silent and/or prodromal motor PD. a Longitudinal fractional anisotropy (FA) changes in the iRBD group (n = 8). Blue lines illustrate the mean skeletonized FA of WM across the two visits. White arrows point to the anatomical location of the cortico-spinal tract. Colour bars represent corrected p values (Follow-up < baseline) by threshold-free cluster enhancement with 10,000 permutations. No significant voxel was found for Follow-up > baseline. b Skeletonized FA comparison between iRBD and controls at follow-up. Blue lines illustrate the mean skeletonized FA of WM across the two groups. Colour bars represent corrected p values for iRBD > healthy controls by Threshold-Free Cluster Enhancement with 10,000 permutations. The threshold p value for comparison of the upper row was 0.05 and of the lower row was 0.1. No significant voxel was found for iRBD < healthy controls. c Whole-brain FA comparison between iRBD and controls at follow-up. Blue and yellow shadows indicate right and left paracentral lobules, respectively, which contain the primary motor cortex sampled in our post-mortem study. Colour bar represents the corrected p values for iRBD > healthy controls by Threshold-Free Cluster Enhancement with 10,000 permutations. No significant voxel was found for iRBD < healthy controls. x, y, and z are MNI (Montreal Neurological Institute) coordinates in the standard space. x ranges from 0 to 181 as from right to left. y ranges from 0 to 217 as from posterior to anterior. z ranges from 0 to 181 as from bottom to top. White arrows in a and b point to the anatomical location of the cortico-spinal tract. Abbreviations: Follow-up < baseline: iRBD group had decreased FA in the longitudinal analysis, Follow-up > baseline: iRBD group had increased FA in the longitudinal analysis, iRBD > healthy control group: iRBD group had higher FA than that of healthy control group, iRBD < healthy control group: iRBD group had lower FA than that of healthy control group