Zeighami Y, et al. - Given the poor utility of commonly used neuroimaging biomarkers in Parkinson disease (PD) in predicting outcomes, researchers examined if PD prognosis could be assessed via assessing an atrophy pattern from whole-brain structural MRI in the drug-naïve early stage. From the Parkinson's Progression Markers Initiative, they recruited 362 de novo PD patients with T1-weighted MRI (n = 222 for the main analysis, 140 for the validation analysis). Findings support the predictive value of a PD-specific network atrophy pattern for progression of motor, cognitive, and global outcome in PD, and further, this patterns were noted to be a better predictor of prognosis than any of the other tested biomarkers. They observed a 3-point annual faster progression in Movement Disorder Society-Unified Parkinson's Disease Rating Scale-part III, faster worsening of posture-instability gait scores, a faster decline in Montreal Cognitive Assessment and a faster annual increase in the global composite z-score in correlation with the tertile with the highest baseline atrophy (ie, the 1st tertile) vs the 3rd tertile (ie, least atrophy).