Clinical Parkinsonism Related Disorders最新文献

{"title":"Confirmation of biallelic VPS11 variants as a cause of complex dystonic syndrome","authors":"Arnaud Storck , Marie Thérèse Abiwarde , Gaelle Hardy , Anne-Sophie Lebre , Sophie Scheidecker , Maria Cristina Antal , Mathieu Anheim , Thomas Wirth","doi":"10.1016/j.prdoa.2025.100419","DOIUrl":"10.1016/j.prdoa.2025.100419","url":null,"abstract":"","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"14 ","pages":"Article 100419"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145927701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hippocampal-striatal interaction in Parkinson’s disease with mild cognitive impairment","authors":"Jingjing Xu ,&nbsp;Sijia Tan ,&nbsp;Xiaohui Zhang ,&nbsp;Minming Zhang ,&nbsp;Xiaojun Xu","doi":"10.1016/j.prdoa.2026.100443","DOIUrl":"10.1016/j.prdoa.2026.100443","url":null,"abstract":"<div><h3>Background</h3><div>Striatal dopaminergic dysfunction and hippocampal degeneration contribute to cognitive impairment in Parkinson’s disease (PD). However, their interaction in PD-related cognitive decline remains unclear.</div></div><div><h3>Objective</h3><div>We aimed to investigate whether asymmetry of striatal dopaminergic integrity and hippocampal subfield volume are associated with cognitive performance in PD, and whether their statistical interaction provides additional explanatory value.</div></div><div><h3>Methods</h3><div>A cohort of 53 participants from the Parkinson’s Progression Markers Initiative (PPMI) was analyzed, including 33 PD with mild cognitive impairment (PD-MCI) patients and 20 PD with normal cognition (PD-NC) patients. All patients had complete 18F-AV-133 vesicular monoamine transporter 2 PET and 3D-T1w imaging. Asymmetry indices (AI) were calculated for striatal 18F-AV-133 standard uptake volume ratio (SUVR) and hippocampal subfield volumes.</div></div><div><h3>Results</h3><div>PD-MCI showed higher AI in caudate and anterior putamen uptake versus PD-NC. Hippocampal CA2/3 and granule cell layer AI correlated with MoCA. Caudate and anterior putamen uptake AI linked to multiple cognitive domains. Regression analysis revealed interactions between anterior putamen SUVR AI and CA2/3 AI on MoCA in PD (p = 0.039), and posterior putamen SUVR AI with CA2/3 AI on MoCA in PD-MCI (p = 0.002).</div></div><div><h3>Conclusion</h3><div>Striatal dopaminergic asymmetry and hippocampal subfield asymmetry are both associated with cognitive impairment in PD. In exploratory regression models, the association between CA2/3 asymmetry and global cognition varied according to the degree of striatal dopaminergic asymmetry. These findings clarified the relationship between hippocampus and dopaminergic pathways in PD with cognitive decline, and deepen understanding of the pathophysiological mechanisms of cognitive impairment.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"14 ","pages":"Article 100443"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147740081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Opicapone in Parkinson’s patients with motor fluctuations: clinical assessments and patient-reported outcomes from the OPTI-ON study","authors":"Olga Klepitskaya ,&nbsp;Peter A. LeWitt ,&nbsp;Camilla Kilbane ,&nbsp;Lauren C. Seeberger ,&nbsp;Stuart H. Isaacson ,&nbsp;Ramon Gil ,&nbsp;Ryan S. Drake ,&nbsp;Galit Kleiner ,&nbsp;Glenn T. Stebbins ,&nbsp;Michael Serbin ,&nbsp;Helena C. Brigas ,&nbsp;Daniel Ramos ,&nbsp;Stacy Rattana ,&nbsp;Jeff Trotter ,&nbsp;Grace Liang","doi":"10.1016/j.prdoa.2026.100435","DOIUrl":"10.1016/j.prdoa.2026.100435","url":null,"abstract":"<div><h3>Introduction</h3><div>This study evaluated treatment outcomes of opicapone when used as add-on to levodopa in US patients with Parkinson’s disease (PD) experiencing OFF episodes in clinical settings.</div></div><div><h3>Methods</h3><div>The prospective, open-label, multicenter, observational OPTI-ON study examined patient characteristics, treatment outcomes, and safety/tolerability of Opicapone over 6 months. Clinician-reported outcomes included the Clinician Global Impression of Change (CGI-C), and Movement Disorder Society-sponsored revision of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) Parts IA and IV. Patient-reported outcomes included the Patient Global Impression of Change (PGI-C), MDS-UPDRS Parts IB and II, and the novel Patient Global Impression of Severity in ON and OFF states (PGI-S ON and OFF) and Non-motor Fluctuation Assessment (NoMoFa).</div></div><div><h3>Results</h3><div>The completer set included 161 patients (mean age, 66.8 years; PD duration, 7.8 years; fluctuation onset, 3.6 years). 38.0% of patients were ‘very much/much improved’ on CGI-C; 48.7% and 57.5% showed improvement on MDS-UPDRS Parts IA and IV, respectively; 23.5% of patients rated themselves ‘very much/much improved’ on PGI-C, and 49.5% and 56.5% reported improvements on MDS-UPDRS Parts IB and II, respectively. On PGI-S ON, the proportions of patients with ‘none/very mild’ PD symptoms during ON times were maintained, while, on PGI-S OFF, the proportion of patients with ‘moderately to extremely severe’ PD symptoms during OFF times decreased by 12.7%. NoMoFa Total Score improved in 48.0% of patients. Opicapone was generally well tolerated.</div></div><div><h3>Conclusions</h3><div>In clinical practice, OPC treatment led to improvements in motor and non-motor fluctuations, quality of OFF episodes, and was generally well tolerated.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"14 ","pages":"Article 100435"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147702941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patterns of weariness-related symptoms in Parkinson’s disease: impact of disease progression and levodopa treatment","authors":"Danielle Hersonsky ,&nbsp;Assaf Benesh ,&nbsp;Edmund Ben-Ami ,&nbsp;Eitan Raveh","doi":"10.1016/j.prdoa.2026.100442","DOIUrl":"10.1016/j.prdoa.2026.100442","url":null,"abstract":"<div><h3>Background</h3><div>Weariness-related symptoms (WRS), i.e. fatigue, daytime sleepiness, and sleep problems are common non-motor symptoms in Parkinson’s disease (PD) that impair quality of life. Although related, they represent distinct clinical domains, and the role of dopaminergic therapy in their progression remains unclear. We compared stable levodopa regimens with levodopa dose escalation to evaluate their impact on WRS evolution.</div></div><div><h3>Methods</h3><div>From a database of 1,521 PD patients, 159 individuals (mean age 64.7 ± 9.36 years; 61.7% male; Hoehn and Yahr stage 0–2) with two assessments 6–18 months apart were included. Patients were grouped into stable medication regimen (SMR) or increased levodopa dose (ILD). Longitudinal changes in fatigue, daytime sleepiness, and nighttime sleep problems were analyzed, including age-stratified comparisons.</div></div><div><h3>Results</h3><div>In the SMR group, daytime sleepiness increased significantly over time (0.21 ± 0.86, P = 0.001), while fatigue and sleep problems remained stable. In contrast, the ILD group showed a significant increase in fatigue (0.15 ± 0.89, P = 0.017), with no changes in daytime sleepiness or sleep problems. Worsening daytime sleepiness under stable medication was confined to older patients (&gt;65 years, P = 0.003), whereas fatigue worsening after levodopa escalation was mainly observed in younger patients (≤65 years, P = 0.03).</div></div><div><h3>Conclusion</h3><div>Daytime sleepiness appears disease-driven and independent of medication changes, while fatigue is more closely associated with levodopa escalation, supporting individualized management and targeted therapeutic development.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"14 ","pages":"Article 100442"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147702942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"One patient, one destiny: A cluster analysis of the Parkinson’s progression Markers Initiative (PPMI) cohort","authors":"Khashayar Dashtipour ,&nbsp;Mehrbod Vakhshoori ,&nbsp;Zahra Hashempour ,&nbsp;Alberto J. Espay ,&nbsp;Mark Ghamsary ,&nbsp;Jacob Jones ,&nbsp;Farzin Pedouim ,&nbsp;Karen Frei ,&nbsp;Ava Baghaei","doi":"10.1016/j.prdoa.2026.100437","DOIUrl":"10.1016/j.prdoa.2026.100437","url":null,"abstract":"<div><h3>Background</h3><div>Parkinson’s disease (PD) is characterized by heterogeneity. While previous efforts have aimed to categorize patients by clinical subtypes, these classifications have not reliably predicted outcomes, underscoring the complexity and variability of disease progression.</div></div><div><h3>Methods</h3><div>Using data from the Parkinson’s Progression Markers Initiative (PPMI), we conducted a longitudinal analysis of 209 individuals with PD over five years. We used cluster analysis to identify trajectory clusters in the progression of motor symptoms. Participants were categorized based on baseline variables, including age, sex, race, BMI, genetic mutation status, medical history, presence of jaw and limb tremors, and alpha-synuclein seeding status. Motor and non-motor outcomes, such as gait abnormalities, dyskinesia, motor fluctuations, dystonia, cognitive impairment, hallucinations, and others, were evaluated, along with the progression of the levodopa equivalent daily dose (LEDD). Sankey plots illustrated patient trajectories from baseline to outcome groups over time.</div></div><div><h3>Results</h3><div>Trajectory cluster analysis of MDS-UPDRS Part III scores identified three progression patterns: slow, intermediate, and rapid, with higher baseline BMI associated with faster motor progression (P &lt; 0.01). Grouping based on baseline features identified 136 distinct patient groups, with substantial dispersion across clinical outcomes. Patients with identical baseline profiles frequently diverged into separate outcome groups. Genetic/SAA stratification also showed marked variability in progression with no significant association across trajectory clusters (P &gt; 0.05).</div></div><div><h3>Conclusion</h3><div>These findings highlight the existence of highly individualized clinical trajectories, even among patients with similar baseline characteristics, within the specific set of baseline variables examined in this study. This emphasizes the need for a personalized, patient-centered approach in both the management and study of Parkinson’s disease.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"14 ","pages":"Article 100437"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147537829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regional dopaminergic dysfunction patterns discriminate Parkinson’s disease from multiple system atrophy parkinsonian subtype","authors":"Dan Xu,&nbsp;Chenhao Jia,&nbsp;Tianhao Zhang,&nbsp;Chao Ren,&nbsp;Wenjia Zhu,&nbsp;Han Wang,&nbsp;Li Huo","doi":"10.1016/j.prdoa.2026.100451","DOIUrl":"10.1016/j.prdoa.2026.100451","url":null,"abstract":"<div><h3>Background</h3><div>Parkinson’s disease (PD) and multiple system atrophy parkinsonian subtype (MSA-P) are clinically similar α-synucleinopathies, making differential diagnosis challenging. This study aimed to identify distinct regional dopaminergic dysfunction patterns using quantitative ¹⁸F-DOPA PET to differentiate the two disorders.</div></div><div><h3>Methods</h3><div>We prospectively recruited 20 PD patients, 12 MSA-P patients, and 9 healthy controls. All underwent ¹⁸F-DOPA PET imaging. Images were normalized using an adaptive probabilistic brain atlas. Voxel-wise and region-of-interest (ROI) analyses were performed with Statistical Parametric Mapping 12, controlling for age, sex, and disease duration. ROI comparisons used ANCOVA with Bonferroni post-hoc tests.</div></div><div><h3>Results</h3><div>Both patient groups showed severe putaminal dopaminergic loss compared to controls. A key differentiator was caudate nucleus involvement: SUVR was significantly lower in MSA-P than in PD (<em>P</em> = 0.031) and controls (<em>P</em> = 0.006), while PD did not differ from controls. Cerebellar SUVR was also significantly reduced in MSA-P compared to PD (<em>P</em> = 0.026) and controls (<em>P</em> = 0.007), despite no clinical cerebellar signs in MSA-P patients. Putamen uptake did not differentiate PD from MSA-P. Voxel-wise analysis confirmed reduced uptake in bilateral caudate, posterior cerebellar lobes, and vermis in MSA-P vs PD. No significant correlations between SUVR and clinical severity were found after correction for multiple comparisons.</div></div><div><h3>Conclusions</h3><div>¹⁸F-DOPA PET reveals distinct topographic patterns: PD shows predominant putaminal impairment with caudate sparing, whereas MSA-P is characterized by concurrent caudate and cerebellar dopaminergic dysfunction. Caudate and cerebellar ¹⁸F-DOPA uptake are potential imaging biomarkers for differentiating MSA-P from PD.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"14 ","pages":"Article 100451"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148178439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EYE movement abnormalities in Parkinson’s disease: optometric screening and rehabilitation","authors":"Reshu Yadav,&nbsp;Dayashankar Rastogi,&nbsp;Shivam Kumar,&nbsp;Partha Chowdhury,&nbsp;Eric Austin","doi":"10.1016/j.prdoa.2026.100468","DOIUrl":"10.1016/j.prdoa.2026.100468","url":null,"abstract":"<div><h3>Background</h3><div>Parkinson's disease (PD) is increasingly recognized as a multisystem disorder in which eye movement abnormalities provide important diagnostic and prognostic insights.</div></div><div><h3>Objective</h3><div>This review synthesizes current evidence on oculomotor disturbances in PD, their clinical relevance, and their potential as biomarkers for early detection and disease monitoring.</div></div><div><h3>Methods</h3><div>A structured narrative review was conducted using PubMed, Scopus, and Web of Science databases (up to July 2025). Although a systematic search strategy was applied, findings were synthesized narratively due to heterogeneity in study designs and outcomes.</div></div><div><h3>Results</h3><div>Across studies, PD patients demonstrated prolonged saccadic latency, reduced vergence amplitudes, and impaired smooth pursuit, often correlating with disease severity. Several abnormalities were detectable in early-stage disease, preceding overt motor dysfunction. Interventions such as prisms, vergence exercises, and vision therapy showed potential benefits in alleviating diplopia and improving visual function. Quantitative eye-tracking measures emerged as promising objective biomarkers for disease monitoring.</div></div><div><h3>Discussion</h3><div>Oculomotor assessment offers significant clinical implications, from supporting early diagnosis and differential recognition of parkinsonian syndromes to guiding rehabilitative strategies that enhance visual quality of life. However, heterogeneity of methodologies and limited longitudinal data constrain generalizability.</div></div><div><h3>Conclusions</h3><div>Eye movement abnormalities represent a valuable, underutilized tool in PD care. Standardization of assessment protocols, integration with neuroimaging, and validation through large-scale longitudinal studies are essential to establish oculomotor metrics as reliable biomarkers for clinical practice.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"15 ","pages":"Article 100468"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13316197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148362738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cerebral hemodynamic changes and their effects on cognitive function in patients with Parkinson's disease complicated with orthostatic hypotension","authors":"Jinyu Wang,&nbsp;Yaqin Yu,&nbsp;Kaili Zhang,&nbsp;Ruipeng Wang,&nbsp;Junwei Zhang,&nbsp;Donghai Li,&nbsp;Weihong Yan","doi":"10.1016/j.prdoa.2026.100469","DOIUrl":"10.1016/j.prdoa.2026.100469","url":null,"abstract":"<div><h3>Objective</h3><div>This article explores the relationship between OH and cerebral hemodynamics in PD patients, and clarifies the correlation between OH and cognitive function in PD patients.</div></div><div><h3>Methods</h3><div>The included PD cases were divided into OH positive and OH negative groups according to Active standing test (AST). In the supine position test, cerebral blood flow velocity (CBFv) and pulsitility index (PI) were continuously monitored by TCD, and blood pressure and heart rate in the supine position and standing position for 1st, 3rd and 5th minute were recorded.</div></div><div><h3>Results</h3><div>In the chi-square test, 87.5% of patients with Parkinson's disease with orthostatic hypotension (PD-OH) had poor W spike correction, while only 12.2% of patients in Parkinson's disease with non-orthostatic hypotension (PD-NOH) group had OH symptoms, and 14.6% of patients had poor W spike correction. MoCA scores were significantly lower, and the prevalence of cognitive decline (CD) was significantly higher, in the OH with poor W spike callback group than in the W spike disappearance (WD) and normal response groups (<em>P</em> &lt; 0.01). The results showed that mean cerebral blood flow velocity ratio (mCBFvR, % of baseline) was slightly positively correlated with MoCA score. Univariate regression analysis of disease duration, LEDD and OH were positively associated with CI in PD patients.</div></div><div><h3>Conclusion</h3><div>CBFv reduction was positively correlated with CD. This study points out that PD patients have poor W spike callback with OH, and then reduces the cerebral blood perfusion in the prolonged upright state, which may explain the impaired cognitive function in PD patients with OH. OH may serve as a “marker” of the overall burden of the disease, rather than being the sole direct cause of cognitive impairment.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"15 ","pages":"Article 100469"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13319372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148370057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The characterization of Parkinson's disease related pain based on the classification system: The severity of neuropathic pain and the clinical profile of nociplastic pain","authors":"Toshiki Tezuka,&nbsp;Tomonori Nukariya,&nbsp;Shohei Okusa,&nbsp;Ryo Ueda,&nbsp;Hiroki Saegusa,&nbsp;Ryotaro Okochi,&nbsp;Yuto Sakai,&nbsp;Yoshihiro Nihei,&nbsp;Jin Nakahara,&nbsp;Morinobu Seki","doi":"10.1016/j.prdoa.2026.100490","DOIUrl":"10.1016/j.prdoa.2026.100490","url":null,"abstract":"<div><h3>Introduction</h3><div>Pain significantly impairs quality of life in Parkinson's disease (PD). While the PD Pain Classification System (PD-PCS) categorizes PD-related pain into nociceptive, neuropathic, and nociplastic pain, the clinical and structural correlates of these subtypes, particularly nociplastic pain, remain poorly characterized. The objective of this study was to elucidate the distinct features of each PD-related pain subtype.</div></div><div><h3>Methods</h3><div>This single-center cross-sectional study involved a two-stage PD-PCS-based evaluation. First, 192 PD patients were assessed for the prevalence of pain subtypes and their associations with demographic and clinical variables. Second, 40 PD patients with pain underwent detailed physician-led assessments using validated motor and non-motor scales, including MDS-UPDRS, KPPS, KPPQ, NMSS, HADS, PDSS-2, PDQ-8, WOQ-9, and VAS. Structural and diffusion MRI analyses, including free-water imaging and neurite orientation dispersion and density imaging, were performed in a subset of participants to explore pain-related neural correlates.</div></div><div><h3>Results</h3><div>Among 192 PD patients in the first survey, 107 (55.7%) reported pain, classified as nociceptive (37.4%), neuropathic (18.7%), nociplastic (23.4%), or PD-unrelated pain (20.6%). Compared with nociplastic pain, neuropathic pain showed higher PD-PCS scores (39.8 ± 29.2 vs 14.3 ± 16.9; <em>p</em> = 0.0014) and higher King's Parkinson's Pain Questionnaire scores (5.8 ± 2.7 vs 2.9 ± 1.5; <em>p</em> = 0.00014). Compared with nociceptive pain, neuropathic pain also showed higher questionnaire scores (5.8 ± 2.7 vs 3.8 ± 2.1; <em>p</em> = 0.013). In the second survey, neuropathic pain was associated with greater motor complications than nociplastic pain (MDS-UPDRS Part IV: 10.2 ± 2.9 vs 3.9 ± 3.4; <em>p</em> = 0.029). In the supplementary MRI analysis, neuropathic pain showed distinct microstructural abnormalities in pain-processing neural networks. Conversely, nociplastic pain showed no distinctive motor/non-motor features or detectable MRI abnormalities, despite a comparable negative impact on quality of life.</div></div><div><h3>Conclusion</h3><div>Neuropathic pain in PD represents a severe phenotype linked to both motor fluctuations and structural brain changes, underscoring the need for mechanism-specific management strategies. By contrast, the absence of defining clinical or structural markers in nociplastic pain highlights it diagnostic challenge and suggests that current assessment tools may insufficiently capture this pain mechanism. These findings emphasize the need for multidimensional and mechanism-oriented approaches to PD-related pain in clinical practice.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"15 ","pages":"Article 100490"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13463971/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148726853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and treatment effects on non-motor symptoms in cervical dystonia: A systematic review and meta-analysis","authors":"Zihao Zhuang,&nbsp;Xiaoyu Wang,&nbsp;Shun Fan,&nbsp;Qingbo Lv,&nbsp;Jingbo Zhai,&nbsp;Jingui Wang,&nbsp;Huanan Li","doi":"10.1016/j.prdoa.2026.100489","DOIUrl":"10.1016/j.prdoa.2026.100489","url":null,"abstract":"<div><h3>Introduction</h3><div>Non-motor symptoms (NMS) substantially impair quality of life in patients with cervical dystonia (CD). Although psychiatric comorbidities are well recognized, the prevalence of sleep disturbance and fatigue in this population remains unclear; likewise, whether therapeutic interventions ameliorate NMS has not been established. This systematic review and meta-analysis evaluated NMS prevalence, identified moderators of heterogeneity, and assessed treatment effects on NMS in patients with CD.</div></div><div><h3>Methods</h3><div>Following PRISMA standards (PROSPERO: CRD42024619105), we searched Embase, PsycINFO, PubMed, and Web of Science through May 1, 2026. We calculated pooled prevalence using random-effects models, and conducted subgroup analyses and meta-regression to identify sources of heterogeneity. Treatment outcomes were assessed using standardized mean differences.</div></div><div><h3>Results</h3><div>Forty-two studies were included. Pooled prevalence rates were: depression 35.2% (95% CI, 30.0% to 40.6%; I² = 84.8%), anxiety 34.0% (95% CI, 27.8% to 40.5%; I² = 85.8%), sleep disturbance 57.1% (95% CI, 46.7% to 67.2%; I² = 84.4%), and fatigue 60.6% (95% CI, 49.1% to 71.6%; I² = 54.9%). Assessment tool type was the most consistent source of heterogeneity. Meta-regression identified female percentage as a potential moderator of depression prevalence; no moderator reached significance for anxiety. Botulinum toxin treatment produced an improvement in depression (SMD = −0.31) and anxiety (SMD = −0.23), but no significant benefit for sleep disturbance. Substantial heterogeneity persisted across most analyses.</div></div><div><h3>Conclusion</h3><div>NMS were highly prevalent in CD, with over half of patients reporting sleep disturbance or fatigue. Assessment tool type was the most consistent source of heterogeneity across outcomes, highlighting the need for standardized NMS assessment protocols. Meta-regression identified female percentage as a potential moderator of depression prevalence. Among interventions, BoNT provided preliminary evidence of modest benefit for mood symptoms but had no effect on sleep. The evidence base for NMS interventions in CD remains preliminary, underscoring the need for trials explicitly aimed at NMS.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"15 ","pages":"Article 100489"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13463814/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148727134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}