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Abstract Dysphagia is a substantial and often underrecognized burden in Parkinson’s disease (PD), and its neural underpinnings remain poorly understood. In this retrospective study, we employed a multimodal neuroimaging approach to investigate structural brain changes associated with dysphagia in PD. We included 105 participants in the age range of 45 to 84 years: 35 PD with dysphagia (PDD), 35 PD without dysphagia (PDnD), and 35 age- and sex-matched healthy controls (HC). Oropharyngeal dysphagia was confirmed through clinical swallowing evaluation or video fluoroscopic swallow study. We obtained T1 and diffusion-weighted MRI from all our participants. We analyzed them using voxel-based morphometry, surface-based morphometry, tract-based spatial statistics, and graph-theoretical structural connectivity analysis. Relative to HC and PDnD groups, the PDD group showed widespread gray matter atrophy ( p p p p
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