Clinical Parkinsonism Related Disorders最新文献

{"title":"Hospital based motor cognitive rehabilitation training. What after? An intervention aimed at patients' support between admissions","authors":"Anna Carollo,&nbsp;Chiara Siri,&nbsp;Greta Manoni,&nbsp;Margherita Canesi","doi":"10.1016/j.prdoa.2026.100472","DOIUrl":"10.1016/j.prdoa.2026.100472","url":null,"abstract":"<div><div>The letter reports on a teleconsultation program for patients with Parkinson's Disease after hospital-based rehabilitation. PwPD and their caregivers were contacted with regular video/phone calls assessing therapy adherence and addressing emerging difficulties. Results showed high satisfaction, continuity of care, and feasibility, confirming telemedicine as a valuable extension of clinical practice.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"15 ","pages":"Article 100472"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13330681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148392002","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":"Analyzing the ‘bradykinesia complex’ in GBA1-associated Parkinson's disease: A series of three cases","authors":"Martina De Riggi,&nbsp;Daniele Birreci,&nbsp;Adriana Martini,&nbsp;Simone Aloisio,&nbsp;Luca Angelini,&nbsp;Anna Sofia Grandolfo,&nbsp;Matteo Bologna","doi":"10.1016/j.prdoa.2026.100462","DOIUrl":"10.1016/j.prdoa.2026.100462","url":null,"abstract":"<div><div>“Although GBA1-associated Parkinson's disease shows distinctive clinical features, the characterization of motor impairment remains limited. We performed OFF- and ON-state kinematic finger-tapping analysis in three Parkinson's disease patients carrying GBA1 variants of different severity, applying the ‘bradykinesia complex’ framework. Quantitative assessment revealed heterogeneous kinematic profiles and variable dopaminergic responsiveness. These findings suggest that kinematic biomarkers may complement clinical evaluation and support phenotypic characterization in GBA1-associated Parkinson's disease.”</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"15 ","pages":"Article 100462"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13292783/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148333280","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":"Longitudinal biomarkers in dementia with Lewy bodies: A systematic review and meta-analysis","authors":"Juliette L. van Alphen,&nbsp;Federico E. Pozzi,&nbsp;Jan Booij,&nbsp;Frederik Barkhof,&nbsp;Mara ten Kate,&nbsp;Charlotte E. Teunissen,&nbsp;Wiesje M. van der Flier,&nbsp;Afina W. Lemstra","doi":"10.1016/j.prdoa.2026.100470","DOIUrl":"10.1016/j.prdoa.2026.100470","url":null,"abstract":"<div><h3>Introduction</h3><div>Dementia with Lewy bodies (DLB) is the second most prevalent neurodegenerative dementia. It is clinically and biologically heterogeneous, yet longitudinal biomarker studies assessing different aspects of neuropathological processes in DLB are scarce. We systematically reviewed the literature to identify biomarkers suitable for tracking disease progression in DLB and to evaluate potential outcome measures for clinical trials by examining which biomarkers show longitudinal changes correlating with clinical progression.</div></div><div><h3>Methods</h3><div>Following PRISMA guidelines, we searched CENTRAL, MEDLINE, Embase, Scopus, and Web of Science for longitudinal biomarker studies in DLB (sample size ≥10, follow-up duration ≥6 months). We conducted meta-analysis of three structural MRI-studies assessing whole-brain atrophy.</div></div><div><h3>Results</h3><div>Of 9162 titles screened, 17 studies met selection criteria including ±460 patients with MCI-LB/DLB. 15 studies included imaging biomarkers (MRI, SPECT, PET) and two studies included fluid biomarkers (plasma, CSF). Except for DAT-SPECT, most studies addressed non-DLB specific neurodegeneration or Alzheimer's disease (AD) pathology. Structural MRI-studies showed greater longitudinal atrophy in AD and mixed DLB + AD versus DLB and controls. Meta-analysis confirmed that DLB-patients were comparable to controls (<em>p</em> = 0.37), but showed lower atrophy rates than AD (<em>p</em> = 0.01). Amyloid-PET and biofluid studies suggested that amyloid accumulation follows typical progression, even in non-AD diagnoses. DAT-SPECT and FDG-PET demonstrated longitudinal changes correlating with clinical progression, showing promise as monitoring biomarkers.</div></div><div><h3>Conclusion</h3><div>No single biomarker currently suffices to track disease progression in DLB. DAT-SPECT and FDG-PET showed promise, but further research is warranted on these and alternative, more disease-specific, accessible and feasible modalities to improve disease monitoring in future clinical trials.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"15 ","pages":"Article 100470"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13316175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148362763","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":"Survival benefit of enteral nutrition and airway interventions in multiple system atrophy","authors":"Katsuya Nishida,&nbsp;Kento Sakashita,&nbsp;Naonobu Futamura","doi":"10.1016/j.prdoa.2026.100499","DOIUrl":"10.1016/j.prdoa.2026.100499","url":null,"abstract":"<div><h3>Introduction</h3><div>Dysphagia in multiple system atrophy (MSA) leads to pneumonia and malnutrition, impacting survival. This study evaluated the association between enteral nutrition (EN) and survival and described outcomes of laryngotracheal separation (LTS).</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 158 patients with probable/definite MSA (2000–2025). Survival from onset was evaluated using Simon–Makuch curves, Mantel–Byar tests with time-dependent EN, and Kaplan–Meier analysis with propensity score matching (PSM) and restricted mean survival time (RMST). Competing risk analyses (Fine–Gray models) assessed the cumulative incidence of death and respiratory interventions (tracheostomy or tracheostomy invasive ventilation [TIV]). Clinical outcomes of LTS (<em>n</em> = 11) were reviewed.</div></div><div><h3>Results</h3><div>Eighty-seven patients received EN; median survival after EN initiation was 4.3 years. Simon–Makuch analysis showed lower survival in the EN group, reflecting late-stage introduction. After PSM, EN was associated with a modest survival advantage at 7 years (RMST difference 0.68 years, <em>P</em> = 0.005). Significant reduction in sudden death occurred in the EN group (15% vs. 30%, <em>P</em> = 0.001). Competing-risk models showed lower death and higher TIV incidence in the EN group, reflecting proactive respiratory management. In the LTS series, mean survival was 14.5 years with no pneumonia-related deaths and preserved limited oral intake, supporting quality-of-life benefits.</div></div><div><h3>Conclusion</h3><div>EN was independently associated with a statistically significant but clinically modest survival advantage, largely by facilitating a comprehensive care pathway including respiratory management. In a small LTS series, the prevention of pneumonia-related death and potential quality-of-life benefits support early structured advance care planning in advanced MSA.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"15 ","pages":"Article 100499"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148951620","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":"Validation and modification of a Chinese smell identification test (CSIT-12) in patients with Parkinson's disease and rapid eye movement sleep behavior disorder","authors":"Xiao-Niu Liang,&nbsp;Xiao-Yue Wang,&nbsp;Jian-Cai Zhu,&nbsp;Yun-Wei Niu,&nbsp;Cong Fu,&nbsp;Hua-Lan Yang,&nbsp;Jian Wang,&nbsp;Huan Yu,&nbsp;Zuo-Bing Xiao,&nbsp;Yi-Min Sun","doi":"10.1016/j.prdoa.2026.100507","DOIUrl":"10.1016/j.prdoa.2026.100507","url":null,"abstract":"<div><h3>Background</h3><div>To enhance olfactory screening for Chinese patients with Parkinson's disease (PD) or rapid-eye movement sleep behavior disorder (RBD) by developing and modifying a Chinese Smell Identification Test 12 (CSIT-12).</div></div><div><h3>Methods</h3><div>In a discovery cohort, 69 PD patients and 47 healthy controls (HCs) were tested on 24 distinct odors using the Sniffin’ Sticks Screening Test 12 (SSST-12) and CSIT-12. The 12 odors with the highest area under the curve (AUC) were selected to construct the Chinese version of the Sniffin’ Sticks Screening Test 12 (C-SSST-12). This newly developed test was then validated in an independent cohort comprising 48 PD patients, 48 RBD patients, and 48 HCs. The reliability and validity of SSST-12, CSIT-12, C-SSST-12, and further abbreviated odor subsets were compared.</div></div><div><h3>Results</h3><div>Scores on SSST-12, CSIT-12, and C-SSST-12 were significantly lower in both PD and RBD compared to HCs (all <em>P</em> &lt; 0.001). Both the CSIT-12 and SSST-12 demonstrated good discriminative capacity for PD versus HCs (CSIT-12: AUC = 0.832, sensitivity = 77.1%, specificity = 83.3%; SSST-12: AUC = 0.913, sensitivity = 85.4%, specificity = 81.3%) and RBD versus HCs (CSIT-12: AUC = 0.881, sensitivity = 85.4%, specificity = 83.3%; SSST-12: AUC = 0.893, sensitivity = 79.2%, specificity = 81.3%). Notably, the C-SSST-12 achieved the highest discriminative performance for PD versus HCs (AUC = 0.930, sensitivity = 81.3%, specificity = 85.4%) and RBD versus HCs (AUC = 0.949, sensitivity = 89.6%, specificity = 85.4%). A 5-odor CSIT-12 subset and a 3-odor C-SSST-12 subset retained high discriminative validity.</div></div><div><h3>Conclusions</h3><div>This study highlights the discriminative value of utilizing culturally familiar odors for the screening of PD and RBD in Chinese populations. Furthermore, the abbreviated odor subsets offer highly efficient, rapid screening options suitable for community-based testing and fast-paced clinical environments.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"15 ","pages":"Article 100507"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149159029","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":"Documented pain phenotypes and interventional pain-care exposure in patients with dystonia: a retrospective text-mining cohort study","authors":"Shachar Zion Shemesh,&nbsp;Tsvia Fay-Karmon,&nbsp;Paz Kelmer,&nbsp;Jose Asprilla,&nbsp;Zaki Hinnawi,&nbsp;Itay Goor-Aryeh,&nbsp;Yotam Hadari,&nbsp;Lior Ungar","doi":"10.1016/j.prdoa.2026.100505","DOIUrl":"10.1016/j.prdoa.2026.100505","url":null,"abstract":"<div><h3>Background</h3><div>Pain is a non-motor manifestation of dystonia, but its anatomical heterogeneity and treatment exposure are incompletely characterized. We described pain phenotypes in patients with dystonia referred to a tertiary pain service.</div></div><div><h3>Methods</h3><div>In this retrospective cohort study, electronic health record text from 2010 to 2026 was collapsed from 108,797 raw rows to 1860 encounters among 129 patients. A Hebrew-English rule-based pipeline identified pain phenotypes and documented treatment exposures. A category-stratified random sample of 129 records was manually audited by a senior neurosurgeon blinded to pipeline output. The primary objective was phenotype distribution; treatment exposures and phenotype-treatment associations were secondary or exploratory.</div></div><div><h3>Results</h3><div>Mean age was 67.0 years (SD 6.0), 61 patients (47.3%) were men, mean age at dystonia onset was 60 years, and all patients had at least four years of documented disease. Phenotype-codable pain was identified in 125 patients (96.9%). The most frequent phenotypes were limb/extremity (72.9%), spine/radicular (72.1%), cervico-occipital (53.5%), neuropathic-descriptor (43.4%), and myofascial/muscle pain (37.2%). At least one prespecified interventional procedure category was documented in 86 patients (66.7%). Cervical dystonia was associated with cervico-occipital pain (69.4% vs 43.8%; OR 2.91, 95% CI 1.38–6.18; <em>P</em> = .006). Treatment associations were interpreted as co-documentation patterns affected by indication bias.</div></div><div><h3>Conclusions</h3><div>Pain in this referral-enriched cohort was anatomically and mechanistically heterogeneous and frequently accompanied by documented procedural and medication exposure. The findings support prospective assessment using validated pain instruments, but do not establish diagnoses, treatment efficacy, or population prevalence.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"15 ","pages":"Article 100505"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149159031","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":"A comparative study of video-based and electromyography-based detection of tics","authors":"Grace Lowor ,&nbsp;Melvin Osei Opoku ,&nbsp;Julieth Gomez ,&nbsp;William Tvenstrup ,&nbsp;Andrea Noy ,&nbsp;Theresa Ackon ,&nbsp;Jackson Cagle ,&nbsp;Chris Butson ,&nbsp;Kelly Foote ,&nbsp;Michael S. Okun ,&nbsp;Aysegul Gunduz","doi":"10.1016/j.prdoa.2026.100438","DOIUrl":"10.1016/j.prdoa.2026.100438","url":null,"abstract":"<div><h3>Background</h3><div>Tourette Syndrome (TS) is a complex neurodevelopmental disorder characterized by motor and vocal tics that vary widely across individuals. Current clinical assessments primarily rely on subjective rating scales, limiting the precision of tic evaluation and treatment outcome monitoring. To improve clinical decision-making, objective, reliable detection methods are needed.</div></div><div><h3>Objectives</h3><div>This study compared the tic-detection performance of video and electromyography (EMG)-based algorithms. We hypothesized that there would be similar accuracy across modalities and that applying multimodal integration would yield potential benefits.</div></div><div><h3>Methods</h3><div>A total of 286 video and EMG sessions were recorded synchronously from 14 participants over three months. Recordings were labeled as “Rest,” “Tic,” and “Move” using a video object detection algorithm and by applying an EMG double-threshold method. Video-based detection was used as the reference for comparison.</div></div><div><h3>Results</h3><div>Overall agreement between modalities was 71.8%. EMG achieved 61.7% accuracy for “Rest” (precision: 72.4%, recall: 75.3%, F1-score: 73.8%). Despite an 81.6% accuracy, EMG performed poorly in detecting tics (precision: 15.1%, recall: 5.3%, F1-score: 7.9%) and voluntary movement (accuracy: 72.2%, precision: 14.5%, recall: 21.7%, F1-score: 17.4%). A Pearson correlation of 0.14 was found between tic frequencies captured by both EMG and video detectors, suggesting a weak positive relationship.</div></div><div><h3>Conclusion</h3><div>While EMG shows promise for detecting tics at rest, its overall stand-alone performance for tic identification was limited. These findings highlight the potential benefits of integrating video and EMG modalities to improve the accuracy and reliability of tic detection and monitoring in the setting of TS.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"14 ","pages":"Article 100438"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147537833","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":"Recent advances in clinical neurophysiology of myoclonus","authors":"Talyta Grippe ,&nbsp;Benedetta Angeloni ,&nbsp;Amitabh Bhattacharya ,&nbsp;Robert Chen","doi":"10.1016/j.prdoa.2026.100457","DOIUrl":"10.1016/j.prdoa.2026.100457","url":null,"abstract":"<div><div>Advances in clinical neurophysiology have transformed the understanding and assessment of myoclonus. Neurophysiological techniques have made it possible to identify the neural generators of myoclonus and have provided the foundation for modern classification systems that integrate clinical phenomenology with physiological mechanisms. Many of these developments were shaped by the work of several research groups worldwide, with major influence from the contributions of Professor Mark Hallett. His studies helped to establish the central role of neurophysiology in the investigation of myoclonus. Through careful neurophysiological experiments and clinical observations, his work clarified the mechanisms underlying cortical and brainstem myoclonus and contributed substantially to the characterization of functional jerks. This review summarizes current approaches to the clinical neurophysiological evaluation of myoclonus and outlines the evolution of classification systems leading to the recent consensus framework proposed by the International Association of Parkinsonism and Related Disorders. Key neurophysiological techniques used in clinical practice are discussed, and emerging quantitative approaches, including machine-learning of neurophysiological signals, are also highlighted as potential tools to improve diagnostic precision and standardization in the evaluation of myoclonus.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"14 ","pages":"Article 100457"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148177651","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":"Long term improvement in quality of life in Parkinson’s disease after deep brain stimulation of the subthalamic nucleus: an observational cohort","authors":"Ka Loong Kelvin Au,&nbsp;Vinay Pahwa,&nbsp;Kelly E. Lyons,&nbsp;Rajesh Pahwa","doi":"10.1016/j.prdoa.2026.100481","DOIUrl":"10.1016/j.prdoa.2026.100481","url":null,"abstract":"<div><h3>Background</h3><div>Long-term quality of life (QoL) outcomes following subthalamic nucleus (STN) deep brain stimulation (DBS) in Parkinson's disease (PD) remain incompletely characterized beyond 10–15 years.</div><div>Objective: To evaluate long term QoL and clinical outcomes in PD patients undergoing bilateral STN-DBS with follow up extending up to 25 years.</div></div><div><h3>Methods</h3><div>Single center, prospective observational cohort study at a tertiary academic medical center. A total of 387 PD patients who underwent bilateral STN DBS were followed longitudinally with annual assessments for up to 25 years. Annual assessments included PDQ-39, Unified Parkinson's Disease Rating Scale (UPDRS), Levodopa equivalent daily dose (LED), Geriatric Depression Scale (GDS), Montreal Cognitive Assessment (MoCA) and Epworth Sleepiness Scale (ESS).</div></div><div><h3>Results</h3><div>Among 387 patients (baseline PDQ-39, 35.34 ± 14.79), QoL improved significantly at year 1 (24.38 ± 14.39; <em>p</em> &lt; 0.001) and year 3 (29.84 ± 15.70; p &lt; 0.001), followed by stabilization at or near baseline through 25 years without sustained worsening. Motor function (UPDRS Part III, OFF state) improved significantly through year 12 (<em>p</em> &lt; 0.001), with sustained reductions in OFF time and dyskinesia through year 20 (<em>p</em> &lt; 0.001). LED was reduced by approximately 50% and remained significantly lower through year 19 (<em>p</em> &lt; 0.001). Cognitive scores declined over time, with significant worsening beginning at year 2 (<em>p</em> &lt; 0.03), and depression scores worsened gradually after year 3 (<em>p</em> = 0.04). Sleepiness improved transiently through year 7 (<em>p</em> = 0.02) before returning to baseline. PDQ-39 subscores showed domain-specific patterns, with sustained worsening observed in communication.</div></div><div><h3>Conclusion</h3><div>Bilateral STN DBS is associated with significant early improvements in QoL followed by long-term stabilization without deterioration below baseline for up to 25 years. These findings suggest that STN DBS provides durable symptomatic benefit and relative preservation of QoL compared with the expected progressive decline in PD. Long-term management should prioritize non-motor symptoms, particularly cognition and communication.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"15 ","pages":"Article 100481"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148557104","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":"Temporal patterns of motor and nonmotor symptom emergence in Parkinson’s disease: a cluster analysis","authors":"Yoko Sugimura ,&nbsp;Toru Baba ,&nbsp;Tomoko Totsune ,&nbsp;Hideki Oizumi ,&nbsp;Takafumi Hasegawa ,&nbsp;Kyoko Suzuki ,&nbsp;Atsushi Takeda","doi":"10.1016/j.prdoa.2026.100423","DOIUrl":"10.1016/j.prdoa.2026.100423","url":null,"abstract":"<div><h3>Background</h3><div>Parkinson’s disease is a heterogeneous disorder characterized by a broad spectrum of motor and nonmotor symptoms. Recent studies suggest that the order of motor and nonmotor symptom development may indicate different subtypes of Parkinson’s disease. However, the temporal occurrence patterns of these symptoms remain unclear.</div></div><div><h3>Objectives</h3><div>This study aims to identify progression patterns of nonmotor symptoms and assess their relationships with the clinical characteristics of Parkinson’s disease.</div></div><div><h3>Methods</h3><div>We evaluated the prevalence and onset time of motor and nonmotor symptoms in 78 non-demented patients with Parkinson’s disease with a disease duration of less than 10 years, all of whom completed questionnaires regarding the presence of these symptoms and the timing of their appearance. We performed a hierarchical cluster analysis based on onset age and the relative onset times of motor and nonmotor symptoms. We then compared clinical characteristics, and cortical morphological changes among the resulting subgroups. Cortical morphology was analyzed in a subset of patients with available brain imaging and was treated as a sub-analysis.</div></div><div><h3>Results</h3><div>We identified three core clusters that exhibited different temporal patterns of symptom emergence in Parkinson’s disease. Cluster 1 was an older-onset group with early sleep problems, poor cognitive function. Cluster 2 was a younger-onset group with typical prodromal nonmotor symptom, mostly constipation. Cluster 3 was another older-onset group with poor cognitive function and many nonmotor symptoms present after the onset of motor symptoms. Structural brain imaging was available for most participants (58/78), and a subset of Cluster 1 showed more pronounced cortical atrophy.</div></div><div><h3>Conclusions</h3><div>Temporal patterns of nonmotor symptom emergence are heterogeneous and are highly influenced by onset age. Older-onset patients showed a higher burden of nonmotor symptoms and worse cognitive function, with symptom emergence occurring either before or after motor symptom onset. Characterizing these symptom-emergence patterns may help refine the clinical classification of Parkinson’s disease and support more individualized evaluation and management.</div></div>","PeriodicalId":33691,"journal":{"name":"Clinical Parkinsonism Related Disorders","volume":"14 ","pages":"Article 100423"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145978293","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}