PURPOSE: While many studies have explored the link between biomarkers and cognitive decline in Parkinson's disease (PD), a more comprehensive approach is needed, combining striatal dopamine depletion, cerebral glucose metabolism, and cognitive assessments. In this study, we investigated the relationships between striatal dopamine transporter (DAT) uptake, cerebral glucose hypometabolism, and cognition, as well as the potential progression pattern of these changes in PD. METHODS: We enrolled 62 patients with PD and 33 healthy controls. The subjects underwent N-(3-[ RESULTS: Compared to the control group, PD patients exhibited glucose hypometabolism in specific cortical regions. DAT uptake in the anterior and posterior putamen was positively correlated with SUVR CONCLUSION: This study highlights the interconnectedness of dopaminergic depletion, cerebral glucose hypometabolism, and visuospatial dysfunction, proposing that striatal DAT uptake may serve as an early biomarker for cerebral hypometabolism and cognitive impairment in PD.