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Abstract Background: Functional near-infrared spectroscopy (fNIRS) is an advanced technique used to assess cortical activation and functional connectivity in the cerebral cortex brain. This study investigates changes in cortical activation patterns among patients with different subtypes of Parkinson’s syndrome during motor tasks. Methods : A total of 63 participants, including 16 healthy controls, 23 patients with Parkinson’s disease (PD), 12 with progressive supranuclear palsy (PSP), and 12 with multiple system atrophy (MSA), underwent fNIRS assessment during various motor tasks. Functional connectivity analysis was conducted under different motor states. During the sit-to-stand task, patients with PSP exhibited significant activation in the bilateral motor cortices ( P P Results : During the 10-second walking task, patients with MSA showed widespread activation across nearly all cortical regions ( P P Conclusions : These findings reveal distinct cortical activation patterns between PSP and PD during the sit-to-stand task and between MSA and PD during walking tasks. Notably, walking speed in PD patients correlated with activation in multiple cortical regions, suggesting a complex neural basis for motor function in this population. The results offer a novel approach for evaluating cortical connectivity in Parkinson’s syndrome. Trial number: ChiCTR2300070467
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