Non‑motor Symptoms in Parkinson’s Disease and their clinical correlates: A prevalence study in Tertiary Care Center in Turkey

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Methods We enrolled all consecutive PD subjects who applied to our movement disorders outpatient clinics between January/2023 and December/2023; and accepted to participate in the study. In addition to the evaluation of the demographic and clinical features, clinical scales, including the MDS-UPDRS, NMSS, and FOOGQ were performed. Results Overall, we enrolled 163 PD subjects with a mean age of 63.9 ± 10.4 (F/M = 27/136). The disease duration was 3.5 (20) y [median (range)]. The median score of the NMSS was 41 points. The NMSs burden levels were severe in 25.2%, and very severe in 25.2% of the subjects. The subitems with the highest scores were sleep/fatigue, mood/cognition, urinary, and miscellaneous. The correlation analyses between the clinical scales and the NMSS scores revealed positive correlations between the NMSS scores and the results of all the clinical scales including the MDS-UPDRS 1,2, 3, 4, and FOGQ. The analyses within the patient group with newly diagnosed PD also revealed also high NMSS scores. Conclusion We reported the first data regarding the NMS burden in PD subjects from Turkey. We found a high prevalence and severity of various domains of NMSs, most being sleep/fatigue, mood/cognition, urinary, and miscellaneous. More than half of the patients had an NMS burden of severe to very severe level. We found that NMSs were prevalent even in the subgroup with newly diagnosed patients. Non‑motor Symptoms Parkinson’s Disease Motor Symptoms Prevalence Turkey Figures Figure 1 Figure 2 Introduction Nonmotor symptoms (NMSs) are a prominent aspect of Parkinson's disease (PD) that can manifest before the onset of motor symptoms and significantly impact the patient's quality of life (QOL) [ 1 ]. Global research on the prevalence of particular NMSs reveals variation, despite reports of similar trends in other sources [ 2 ]. Ravan et al. described nocturia as the most common NMS in an Indian cohort of PD [ 3 ]. Krishnan et al. found sleep/fatigue issues to be the commonest NMS [ 4 ], whereas mood/apathy was found to have the highest scores in another multicentre study from Europe [ 5 ]. The NMSs almost inevitably emerge with disease progression, and they dominate the clinical picture of advanced PD [ 6 , 7 ]. On the other hand, various aspects of these symptoms may exist even prior to the motor manifestations of PD or dominate the clinical picture since the early phase of the disease [ 8 ]. The evaluation of the NMSs among distinct phases of the disease and the clarification of the clinical correlates of the NMSs contribute substantial topics for further deliberations. Up to our knowledge, there is no data regarding the prevalence and severity of NMSs in the Turkey cohort. Besides, the clinical burden of NMSs, specifically in newly diagnosed patients, is unclear. We first aimed to investigate the involvement of NMSs in our consecutive PD cohort systematically and reveal the possible clinical correlates. Based on a previous method [ 9 ], we also sought to find out the NMS burden in our cohort. Finally, via our method, our objective was to determine the clinical significance of NMSs across distinct stages of the disease. Methods The study is based on a prospective collection of data from patients diagnosed with PD defined according to Movement Disorders Society clinical diagnostic criteria for PD [ 10 ]. We enrolled all consecutive PD subjects who applied to our movement disorders outpatient clinics at Etlik City Hospital between January/2023 and December/2023; and accepted to participate in the study. In addition to the evaluation of the demographic and clinical features, we performed comprehensive assessments including scales to evaluate both motor and nonmotor features. To evaluate the disease severity, the Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS) [ 11 ] was performed during the medication ‘off’ state in all subjects. The scores of the MDS-UPDRS subparts (1, 2, 3, and 4) were also calculated and they were used for further analyses. In addition to the MDS-UPDRS part 1, the nonmotor symptoms scale (NMSS) was performed for a more comprehensive evaluation of the NMSs [ 12 ]. The classification of patients according to the NMSS in 5 stratified levels of burden were performed, which was recently proposed as non-motor symptoms burden levels (NMSB) [ 9 ]. To evaluate the possible motor clinical correlated in detail, freezing of gait (FOG) was evaluated using the Freezing of Gait Questionnaire (FOGQ) [ 13 ] in all individuals. The informed consent form has been obtained from every participant. Patients with major comorbidity other than PD that could affect the clinical assessments, those who have dementia (based on the clinical assessments), and those who did not cooperate to the evaluations were excluded. The ethics committee approval for the study was obtained from the clinical research ethics committee unit of Etlik City Hospital. Statistical Analyses Univariate descriptive analyses were used for reporting sample-level demographic and clinical characteristics including the clinical scales. The independent samples’ two-tailed t-test for normal distribution data or Mann–Whitney U-test for non-normal data were used to compare the demographic data, clinical features, and clinical scales including all the sub scores of the NMSS, between the tremor-dominant (TD) and akinetic-rigid (AR) subtypes. The correlation analyses were performed to investigate the association between the clinical parameters (Pearson’s for parametric distributions and Spearman’s for nonparametric distributions), particularly focusing on the NMSS. The comparisons of the clinical features focusing particularly on the NMSs were made between the patient group receiving newly the diagnosis of PD and others. The statistical analyses were performed using IBM SPSS, version 26. Results In this study, we included 163 PD subjects with a mean age of 63.9 ± 10.4 (F/M = 27/136). The disease duration was 3.5 (20) y [median (range)]. The median scores of the MDS-UPDRS-1, MDS-UPDRS-2, MDS-UPDRS-3, MDS-UPDRS-4 were 9.5 (range = 36), 9 (range = 43), 28 (range = 91) and 2 (range = 17) points, respectively. The median score of the FOGQ was 4 (range = 24) points and the median score of the NMSS was 41 points (range 229). The NMS burden levels were mild in 23.9%, moderate in 24.5%, severe in 25.2%, and very severe in 25.2% of the subjects. The subitems with highest scores were sleep/fatigue, mood/cognition, urinary and miscellaneous (Table 1 ). On the other hand, the most prevalent subitems were related to the sleep/fatigue (85.9%), gastrointestinal tract (77.3%), urinary (75.5%) and miscellaneous (75.5%) domains (Supplementary Table 1). The comparisons between the tremor-dominant (TD) and akinetic-rigid (AR) subtypes revealed that the groups were similar in terms of age, gender, and disease duration. Among the clinical scales, only the MDS-UPDRS part 1 scores differed between groups (9 y versus 13 y, p = 0.012) (Table 2 ). Of note, the NMSS sub scores also did not differ between male and female subjects (Supplementary Table 2). The correlation analyses between the clinical scales and the NMSS scores revealed positive correlations between the NMSS scores and the results of all the clinical scales including the MDS-UPDRS 1,2, 3, 4, and FOGQ. Besides, the FOGQ scores correlated positively with all motor and non-motor clinical scales (Table 3 ). The correlation analyses between the clinical scales and the NMSS sub scores revealed that the MDS-UPDRS 1 scores correlated positively with all the sub scores of the NMSS. On the other hand, there were positive correlations between the motor sub scores and most of the NMSS subitems. Such that, the MDS-UPDRS part 1 scores and the FOGQ scores were found to be correlated with all the subitems of the NMSSS, except the NMSS-attention. The other correlation analyses revealed that only the cardiovascular sub scores showed positive correlation with age. On the other hand, the scores of various NMSS subitems correlated positively with disease duration, including the sleep/fatigue, mood/cognition, perceptual problems/hallucination, gastrointestinal tract, urinary, sexual function, miscellaneous domains (Table 4 ). The analyses within the patient group with newly diagnosis of PD also revealed high NMSS scores. Of note, the NMS burden levels were mild in 30.4%, moderate in 32.6%, severe in 21.7%, and very severe in 13.0% of the subjects. The highest three sub scores for NMSS in this group were sleep/fatigue, miscellaneous and urinary sub scores, respectively (Fig. 2 ). Remarkably, although the scores regarding the motor severity were all lower in the newly diagnosed group in comparison to those with previous diagnosis, the scores of the various subitems of the NMSS did not differ between groups (Table 5 ). Discussion We found that the NMS burden load was severe in a quarter of the groups whereas another quarter of the patients had a very severe NMS burden load. Almost all patients suffered at least from one NMSs. Eighty six percent of the patients suffered from symptoms related to sleep/fatigue complaints and frequency of various other domains of NMSs including gastrointestinal tract, urinary, miscellaneous, and attention/memory was higher than 70% one by one. There rates were higher than in most of the other studies [ 7 , 14 , 15 ]. In a recent study by Bugalho et al., the authors investigated the data of 134 consecutive PD subjects and found that sleep/fatigue, affect/cognition, attention/memory were the most frequent complaints among NMSs [ 16 ]. They noted a prevalence above 80% similar to our results. However, in our group, the domains related to urinary and miscellaneous were more prominent, following the sleep/fatigue subitem. Sahu et al. also found high rates of NMS burden in their PD cohort [ 2 ]. Such that, every patients (n = 150) experienced NMS and 90% had more than five NMSs [ 2 ]. They found that the miscellaneous was the most prevalent domain of NMSS, followed by sleep/fatigue, gastrointestinal tract, and mood/cognition[ 2 ]. Martinez-Martin et al. showed the highest scores in the mood/apathy, sleep/fatigue, urinary, and miscellaneous domains, respectively [ 5 ]. As understood, there are some variations among studies in this respect [ 2 , 5 , 7 , 14 , 15 ]. Another issue may be related to the specificity of these symptoms to PD pathology and their impact in the QOL indexes of patients. Various recent studies have remarked on the impact of NMSs on QOL indexes of patients [ 5 , 9 , 16 ]. Such that, NMSs were reported to exert a stronger influence in QOL indexes than the motor symptoms in a recent two cohort studies from distinct regions [ 5 , 16 ]. In one of these previous studies, mood/apathy was found to have the strongest influence in QOL of PD subjects [ 16 ]. In the other study on 411 PD subjects [ 5 ], the authors found high correlations between the total NMSS scores and QOL status measured by PDQ-39. Among the subitems, the sleep/fatigue and the mood/apathy showed highest correlations with QOL indexes [ 5 ]. On the other hand, Karri et al found that almost all the subdomains of NMS except for perceptual, urinary, and sexual domains had shown a stronger correlation with PDQ‑39 score than H and Y stage [ 15 ]. We found the domains related to miscellaneous, gastrointestinal and urinary symptoms among the prevalent subtypes; however, the domain which was most prevalent and had highest scores was sleep/fatigue. On the other hand, we did not include a quantitative assessment of QOL indexes which avoid us to investigate the differing impact of NMSs in QOL separately. However, in all the individuals, we evaluated the NMS burden levels which were shown to integrate the frequency and severity of NMSs and reflect the disease stage [ 12 ]. Another critical point of our study was that we also examined the NMSs in the subgroup of newly diagnosed patients. We also compared the presence and severity of these features with the remaining patient group which may provide contribute clinical perspectives. The appearance of NMSS at first presentation may not be apparent, and they are frequently overlooked and untreated [ 15 ]. Therefore, determining the precise patterns of NMSs incidence in relation to the onset of motor symptoms is critical to understand how the disease evolves and how the NMS contributes to the morbidity of PD subjects leading to hospital admission [ 15 ]. On the other hand, we know that the NMSs may also be encountered in normal aging subjects [ 4 ]. However, these symptoms are found to be ubiquitous, more frequent, and more severe in PD subjects in comparison to age-matched controls [ 4 ]. Particularly, cardiovascular, mood/cognition, and perceptual problems/hallucinations domains were rarely involved in age-matched controls [ 4 ]. Ergo, the detailed assessment of the NMSs in those with initial diagnosis and previous diagnosis may also provide contributions to our understanding the temporal evolution of the disease and regarding the diagnostic purposes. Of note, the prevalence and severity of NMSs evaluated by NMSS were strictly high in even our newly diagnosed PD subjects. Such that, more than one third of our patients with newly diagnosed PD had a severe-very severe NMS burden load. Besides there was no difference in many of the NMSS sub scores including the cardiovascular, mood/cognition, attention-memory, urinary, and miscellaneous subitems between newly and previous diagnosed groups. However, all the scores of the motor scales were higher in the latter group which might suggest that the NMSs have an apparent clinical impact since the initial phase of the diagnosis. However, we cannot make a definitive conclusion since we did not include a control group. Finally, the diagnostic contribution of NMSs may also be an intriguing issue that needs to be addressed in future-related studies. On the other hand, we found that the NMSS total score showed low-moderate correlations with various motor severity scores including the disease duration, the scores of the MDS-UPDRS sub parts, and FOGQ. In the largest cohort published by Chaudhuri KR et al., the authors analysed the data of 935 consecutive PD subjects and found moderate correlations between the motor disturbance ratings (SCOPA-Motor) and the NMSS scores [ 9 ]. However, they noted that the correlations strengthened in the most advanced stage of the disease. Another study in 2011 by Krishnan et al. reported high correlations between the NMSS scores and the H and Y stage in their study group including 174 PD subjects [ 4 ]. On the other hand, a more recent study in Indian cohort did not find correlations between the NMSS score and the H and Y stages [ 2 ]. In the other study conducted in Jordan, the authors revealed that the NMSS did not show a correlation with the age, gender, or disease duration as defined by the classical motor symptoms [ 7 ]. The discordance between these studies might be related to the motor stages of the patients included which differed between the studies. For instance, patients enrolled in the study by Sahu et al. mostly constituted from those with mild disease stage, and those with Modified H and Y stage 4 or 5 were very rare [ 2 ]. In our group, the median score for the MDS-UPDRS-3 was 28 and the scores regarding the motor complication section was low (median 2 points) showing rather a population at mild-moderate disease stage. Overall, they also found that total NMSS score increased with increasing duration of disease [ 2 ]. We also found an increasing NMSS score with increasing disease duration. However, the correlation coefficient was lower (CC:0.330, p = 0.00) in comparison to the correlations with motor scales. Of note, the Krishnan et al. found that the NMSs increased with age in controls whereas age had no effect on NMSs in PD subjects [ 4 ]. In accordance with this, we also did not determine corelation with age or disease onset age. On the other hand, the subgroup analyses revealed only the cardiovascular sub scores showed positive correlation with age. However, the scores of various subitems correlated positively with disease duration, including the sleep/fatigue, mood/cognition, perceptual problems/hallucination, gastrointestinal tract, urinary, sexual function, miscellaneous domains. Remarkably, the cardiovascular domain was among the domains with lowest scores in our cohort; and did not differ between the newly diagnosed and previously diagnosed groups. Therefore, our results may suggest that the cardiovascular domain of the NMSS may not be specific to PD, as it was not a frequent domain, and no association was found with the increasing severity of the disease and duration. Besides, based on our findings of correlations with the NMSS subitems, our results may support the literature data regarding the increased NMS burden with increasing motor stage [ 4 , 9 ]. However, future studies are warranted to clarify the controversies in this regard. Of note, the association between the NMS and FOG which represent a motor phenomenon may constitute another interesting topic of discussion. There is evidence regarding a close association between the FOG and the existence of NMSs including urinary dysfunction, cognitive impairment, hallucinations, and psychosis [ 17 ]. The association between the cognitive impairment, hallucination and FOG is rather an emphasized issue[ 17 , 18 ]. We found that all the subitem, except the attention/memory, showed positive correlations with FOGQ scores. However, all of them were low correlations among which the sleep/fatigue and the gastrointestinal tract domain scores had the highest correlations with FOGQ scores. In conclusion, we reported the first data regarding the NMS burden in PD subjects from Turkey. In our group constituting of mild-moderate motor disease stage PD subjects, we found high prevalence and severity of various domains of NMSs, most being the sleep/fatigue, mood/cognition, urinary and miscellaneous. More than half of the patients had NMS burden level of severe-very severe. Finally, the occurrence of the NMSs was prevalent even at the subgroup with newly diagnosed patients. Our findings draw attention to the NMSs as cardinal features of PD throughout all the disease stage. The recognition and early identification of these features are surely warranted for optimal diagnosis as well as better clinical outputs. Abbreviations MDS-UPDRS; Movement Disorder Society- sponsored revision of the Unified Parkinson's Disease Rating Scale, NMSS; Nonmotor symptoms scale (NMSS), FOGQ; Freezing of gait questionnaire. Declarations Compliance with ethical standards The ethical approval has been obtained from the local committee of the Etlik City Hospital. Informed consent form has been obtained from the patient. Declaration of conflict of interest: None. Acknowledgments: None. Author Contributions: (1) Research project: A. Conception, B. Organisation, C. Execution; (2) Statistical Analysis: A. Design, B. Execution, C. Review and Critique; (3) Manuscript Preparation: A. Writing of the first draft, B. Review and Critique. HO: 1A, 1B, 1C, 3A, 3B; SSC; 1A, 3B. Funding : None. References P. Barone, R. Erro, M. Picillo, Quality of Life and Nonmotor Symptoms in Parkinson's Disease, International review of neurobiology 133 (2017) 499–516. A.M. Sulagna Sahu, Samar Biswas, Valentina Leta, Katarina Rukavina, Shyamal Kumar Das, Atanu Biswas, Burden of nonmotor symptoms in Parkinson’s disease patients from eastern India, Annals of Movement Disorders (2021). A. Ravan, F.M. Ahmad, S. Chabria, M. Gadhari, C.S. 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Tables Table 1 The demographic and clinical characteristics of the overall group (n = 163) Age, mean ± SD 63.9 ± 10.4 Gender, F/M 27/136 Disease onset side (R/L/Bil) 83/67/4 Disease subtype, (TD/AR) 100/56 RBD, n/% 53/163 (%32.5) Anosmia, n/% 52/163 (% 31.9) Constipation, n/% 99/163 (% 60.7) NMS burden levels No, 0 0.6% Mild, 1–20 23.9% Moderate, 21–40 24.5% Severe, 41–70 25.2% Very severe, ≥ 70 25.2% Median (Range) Mean Standard deviation Disease duration 3.5 (20) 5.0 4.6 MDS-UPDRS-1 9.5 (36) 11.4 8.0 MDS-UPDRS-2 9 (43) 11.9 10.0 MDS-UPDRS-3 28 (91) 31.0 19.4 MDS-UPDRS-4 2 (17) 3.4 4.2 FOGQ 4 (24) 5.7 5.5 NMSS total score 41 (229) 51.0 41.8 NMSS-cardiovascular 0.0 (18) 2.0 3.3 NMSS-Sleep/fatigue 7 (44) 9.5 8.6 NMSS-Mood/Cognition 4 (72) 9.5 12.7 NMSS-Perceptual problems/hallu 0.0 (62) 1.8 6.3 NMSS-Attention/memory 3 (36) 4.4 5.5 NMSS-Gastrointestinal tract 4 (38) 5.7 6.6 NMSS-Urinary 4 (36) 7.8 8.9 NMSS-Sexual function 0.0 (24) 3.8 6.1 Miscalleneous 4 (36) 6.8 7.8 Abbreviations: F/M; Female/Male, TD/AR; Tremor-dominant/Akinetic-rigid, RBD; REM sleep behavior disorder, MDS-UPDRS; MDS-Sponsored Revision of the Unified Parkinson's Disease Rating Scale, FOGQ; Freezing of gait questionnaire, NMSS; Nonmotor symptom scale. Table 2 Comparison of the demographic and clinical features between the tremor-dominant and Akinetic-rigid patient groups. Tremor-dominant Akinetic-rigid p-value Age 68 (49) 60.5 (43) 0.037 Gender, F/M 16/87 15/43 0.161 Disease duration 3 (19) 4 (17) 0.370 MDS-UPDRS-1 9 (31) 13 (35) 0.012 MDS-UPDRS-2 9 (39) 12 (43) 0.286 MDS-UPDRS-3 26 (91) 31 (79) 0.436 MDS-UPDRS-4 0 (15) 3 (17) 0.182 FOGQ 4 (24) 5 (39) 0.109 NMSS total score 49 (219) 45 (228) 0.713 NMSS-cardiovascular 0 (12) 0 (18) 0.442 NMSS-Sleep/fatigue 7 (44) 8 (39) 0.850 NMSS-Mood/Cognition 4 (72) 7.5 (49) 0.537 NMSS-Perceptual problems/hallucination 0 (62) 0 (30) 0.665 NMSS-Attention/memory 3 (36) 3.5 (24) 0.799 NMSS-Gastrointestinal tract 4 (32) 4 (38) 0.795 NMSS-Urinary 4 (36) 5 (36) 0.686 NMSS-Sexual function 0 (24) 1 (21) 0.226 Miscellaneous 4 (36) 5 (33) 0.222 Abbreviations: MDS-UPDRS; MDS-Sponsored Revision of the Unified Parkinson's Disease Rating Scale, FOGQ; Freezing of gait questionnaire, NMSS; Nonmotor symptom scale. Table 3 The correlation analyses between the clinical scales within the whole group (n = 163). Age Disease duration MDS-UPDRS-1 MDS-UPDRS-2 MDS-UPDRS-3 MDS-UPDRS-4 MDS- UPDRS Total FOGQ NMSS Age CC 10.000 -0.014 0.103 0.039 0.052 -0.231 ** -0.025 0.050 -0.005 P . 0.863 0.189 0.617 0.506 0.003 0.748 0.527 0.948 Disease onset age CC 0.901 ** -0.394 ** -0.021 -0.147 -0.138 -0.369 ** -0.219 ** -0.135 -0.126 P 0.000 0.000 0.787 0.063 0.081 0.000 0.005 0.088 0.112 Disease duration CC -0.014 10.000 0.378 ** 0.504 ** 0.513 ** 0.511 ** 0.565 ** 0.471 ** 0.330 ** P 0.863 . 0.000 0.000 0.000 0.000 0.000 0.000 0.000 MDS- UPDRS-1 CC 0.103 0.378 ** 10.000 0.678 ** 0.416 ** 0.396 ** 0.621 ** 0.465 ** 0.563 ** P 0.189 0.000 . 0.000 0.000 0.000 0.000 0.000 0.000 MDS-UPDRS-2 CC 0.039 0.504 ** 0.678 ** 10.000 0.580 ** 0.532 ** 0.767 ** 0.651 ** 0.532 ** P 0.617 0.000 0.000 . 0.000 0.000 0.000 0.000 0.000 MDS- UPDRS-3 CC 0.052 0.513 ** 0.416 ** 0.580 ** 10.000 0.602 ** 0.790 ** 0.597 ** 0.367 ** P 0.506 0.000 0.000 0.000 . 0.000 0.000 0.000 0.000 MDS- UPDRS-4 CC -0.231 ** 0.511 ** 0.396 ** 0.532 ** 0.602 ** 10.000 0.621 ** 0.521 ** 0.393 ** P 0.003 0.000 0.000 0.000 0.000 . 0.000 0.000 0.000 MDS- UPDRS-Total CC -0.025 0.565 ** 0.621 ** 0.767 ** 0.790 ** 0.621 ** 10.000 0.678 ** 0.499 ** P 0.748 0.000 0.000 0.000 0.000 0.000 . 0.000 0.000 FOGQ CC 0.050 0.471 ** 0.465 ** 0.651 ** 0.597 ** 0.521 ** 0.678 ** 10.000 0.434 ** P 0.527 0.000 0.000 0.000 0.000 0.000 0.000 . 0.000 Abbreviations: MDS-UPDRS; MDS-Sponsored Revision of the Unified Parkinson's Disease Rating Scale, FOGQ; Freezing of gait questionnaire, NMSS; Nonmotor symptom scale. Table 4 The correlation analyses between the clinical scales and the NMSS sub scores (n = 163). NMSS-cardiovascular NMSS-sleep/fatigue NMSS-mood/cognition NMSS-hallucination NMSS-attention/memory NMSS-gastrointestinal NMSS-urinary NMSS-sexual NMSS-miscellaneous Age CC 0.163 * -0.077 -0.095 0.046 -0.014 0.096 0.153 -0.186 * -0.144 P 0.038 0.327 0.227 0.557 0.863 0.222 0.051 0.017 0.067 Disease onset age CC 0.166 * -0.152 -0.203 * -0.066 -0.022 -0.051 0.096 -0.206 ** -0.246 ** P 0.035 0.055 0.010 0.409 0.781 0.525 0.227 0.009 0.002 Disease duration CC -0.028 0.182 * 0.233 ** 0.283 ** 0.044 0.362 ** 0.186 * 0.243 ** 0.254 ** P 0.724 0.020 0.003 0.000 0.573 0.000 0.017 0.002 0.001 MDS-UPDRS-1 CC 0.198 * 0.378 ** 0.404 ** 0.331 ** 0.291 ** 0.333 ** 0.448 ** 0.304 ** 0.299 ** P 0.011 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 MDS-UPDRS-2 CC 0.222 ** 0.406 ** 0.418 ** 0.333 ** 0.130 0.362 ** 0.423 ** 0.275 ** 0.195 * P 0.004 0.000 0.000 0.000 0.098 0.000 0.000 0.000 0.012 MDS-UPDRS-3 CC -0.008 0.264 ** 0.250 ** 0.271 ** 0.094 0.247 ** 0.269 ** 0.234 ** 0.187 * P 0.919 0.001 0.001 0.000 0.231 0.001 0.001 0.003 0.017 MDS-UPDRS-4 CC 0.002 0.262 ** 0.277 ** 0.214 ** 0.088 0.261 ** 0.215 ** 0.313 ** 0.284 ** P 0.983 0.001 0.000 0.006 0.262 0.001 0.006 0.000 0.000 MDS-UPDRS-Total CC 0.052 0.387 ** 0.367 ** 0.344 ** 0.147 0.316 ** 0.345 ** 0.384 ** 0.274 ** P 0.510 0.000 0.000 0.000 0.062 0.000 0.000 0.000 0.000 FOGQ CC 0.177 * 0.352 ** 0.290 ** 0.275 ** 0.096 0.338 ** 0.288 ** 0.217 ** 0.250 ** P 0.023 0.000 0.000 0.000 0.225 0.000 0.000 0.005 0.001 Abbreviations: MDS-UPDRS; MDS-Sponsored Revision of the Unified Parkinson's Disease Rating Scale, FOGQ; Freezing of gait questionnaire, NMSS; Nonmotor symptom scale. Table 5 The comparisons of the clinical features and clinical scales between the newly diagnosed patient group and those with previous diagnosis. Newly diagnosis Patients with previous diagnosis Sig. Age, median (range) 66.5 (55) 64 (45) 0.351 Gender, F/M 6/40 21/96 0.601 RBD 10/46 41/117 0.064 Constipation 21/46 76/117 0.012 Anosmia 13/46 39/117 0.479 MDS-UPDRS-1, median (range) 6 (23) 12 (36) 0.000 MDS-UPDRS-2, median (range) 5 (29) 12 (43) 0.000 MDS-UPDRS-3, median (range) 17 (68) 33 (86) 0.000 MDS-UPDRS-4, median (range) 0 (9) 4 (17) 0.000 MDS-UPDRS-Total, median (range) 25 (97) 56 (140) 0.000 FOGQ, median (range) 2 (14) 5 (24) 0.001 NMSS total score, median (range) 30 (183) 48.5 (228) 0.010 NMSS-cardiovascular, median (range) 0 (12) 0 (18) 0.323 NMSS-Sleep/fatigue, median (range) 6 (32) 8 (39) 0.034 NMSS-Mood/Cognition, median (range) 1.5 (48) 5.5 (72) 0.136 NMSS-Perceptual problems/hall, median (range) 0 (2) 0 (62) 0.002 NMSS-Attention/memory, median (range) 2 (24) 3 (36) 0.184 NMSS-Gastrointestinal tract, median (range) 2 (25) 5 (38) 0.008 NMSS-Urinary, median (range) 3 (36) 6 (36) 0.366 NMSS-Sexual function, median (range) 0 (24) 1 (24) 0.007 Miscellaneous, median (range) 3.5 (20) 5 (36) 0.157 NMS burden levels No, 0 2.2% 0% 0.087 Mild,1–20 30.4% 21.9% Moderate, 21–40 32.6% 21.1% Severe, 41–70 21.7% 26.3% Very severe, ≥ 70 13% 29.8% Abbreviations: RBD; REM sleep behavior disorder; MDS-UPDRS; MDS-Sponsored Revision of the Unified Parkinson's Disease Rating Scale, FOGQ; Freezing of gait questionnaire, NMSS; Nonmotor symptom scale. Additional Declarations No competing interests reported. Supplementary Files SupplementaryTable1.docx Supplementary Table 1. The prevalences of the domains of the nonmotor symptoms. SupplementaryTable2.docx Supplementary Table 2.The comparative analyses of the scores of the NMSS subitems between female and male PD subjects. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-3915127","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":270570334,"identity":"8cf219b0-6854-4f5b-b00a-251edbbb3161","order_by":0,"name":"Halil Onder","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA0ElEQVRIiWNgGAWjYBACAwbmhgMPGJgZGNgbQCRRWhgbDiSAFPMcIEELA1iLRAKRWszZDzYeSNxhLWc+843h54IKGwb+9u4EvFosexIbDiSeSTeWuZ1jLD3jTBqDxJmzG/A77ABIS9vhxBnSOQbSvG2HGQwkcgloOf8QrKV+huQZ49/EabkBsSVBQoLHjEhbboBtSTecwZNWZs1zJo2HsF/OJx/+8LHNWl6C/fDm2zwVNnL87b34tSABDgMQyUOschBgf0CK6lEwCkbBKBhBAAC9VUr+A5RcEgAAAABJRU5ErkJggg==","orcid":"","institution":"Etlik City Hospital","correspondingAuthor":true,"prefix":"","firstName":"Halil","middleName":"","lastName":"Onder","suffix":""},{"id":270570335,"identity":"ad0314a9-2681-41d9-b9ce-04594445b8fd","order_by":1,"name":"Selcuk Comoglu","email":"","orcid":"","institution":"Etlik City Hospital","correspondingAuthor":false,"prefix":"","firstName":"Selcuk","middleName":"","lastName":"Comoglu","suffix":""}],"badges":[],"createdAt":"2024-01-31 21:14:14","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-3915127/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-3915127/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":50672648,"identity":"10c30a55-c086-483f-86d7-01ebe1cf9e7f","added_by":"auto","created_at":"2024-02-05 14:53:36","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":70776,"visible":true,"origin":"","legend":"\u003cp\u003eThe graphic showing the non-motor symptoms scale sub scores within the whole group(n=163).\u003c/p\u003e","description":"","filename":"Figure1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-3915127/v1/ae2adca3279d754194a41086.jpg"},{"id":50672649,"identity":"bdfe226c-7a2f-4c3d-8526-d829f63a46ce","added_by":"auto","created_at":"2024-02-05 14:53:36","extension":"jpg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":66204,"visible":true,"origin":"","legend":"\u003cp\u003eThe graphic showing the non-motor symptoms scale sub scores within the patient group of newly diagnosed Parkinson’s disease subjects.\u003c/p\u003e","description":"","filename":"Figure2.jpg","url":"https://assets-eu.researchsquare.com/files/rs-3915127/v1/9958892ab23a66e8fb249b38.jpg"},{"id":53810207,"identity":"1e069311-2c73-4f6c-9f2f-67d392e26c4e","added_by":"auto","created_at":"2024-03-31 13:52:51","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":400844,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-3915127/v1/a56b324d-190a-44eb-a4d0-43a6ba0b6633.pdf"},{"id":50672650,"identity":"3d695557-0181-45d2-b4f9-11df3d0013c0","added_by":"auto","created_at":"2024-02-05 14:53:36","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":14507,"visible":true,"origin":"","legend":"\u003cp\u003eSupplementary Table 1. The prevalences of the domains of the nonmotor symptoms.\u003c/p\u003e","description":"","filename":"SupplementaryTable1.docx","url":"https://assets-eu.researchsquare.com/files/rs-3915127/v1/68585c166ae89ed27e417d52.docx"},{"id":50672651,"identity":"3a005e19-5ee2-4c30-8131-7ed1c18d0ce9","added_by":"auto","created_at":"2024-02-05 14:53:36","extension":"docx","order_by":2,"title":"","display":"","copyAsset":false,"role":"supplement","size":15163,"visible":true,"origin":"","legend":"\u003cp\u003eSupplementary Table 2\u003cstrong\u003e.\u003c/strong\u003eThe comparative analyses of the scores of the NMSS subitems between female and male PD subjects.\u003c/p\u003e","description":"","filename":"SupplementaryTable2.docx","url":"https://assets-eu.researchsquare.com/files/rs-3915127/v1/b4a4e52608a3eacf37c2d140.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Non‑motor Symptoms in Parkinson’s Disease and their clinical correlates: A prevalence study in Tertiary Care Center in Turkey","fulltext":[{"header":"Introduction","content":"\u003cp\u003eNonmotor symptoms (NMSs) are a prominent aspect of Parkinson's disease (PD) that can manifest before the onset of motor symptoms and significantly impact the patient's quality of life (QOL) [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Global research on the prevalence of particular NMSs reveals variation, despite reports of similar trends in other sources [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Ravan et al. described nocturia as the most common NMS in an Indian cohort of PD [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Krishnan et al. found sleep/fatigue issues to be the commonest NMS [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e], whereas mood/apathy was found to have the highest scores in another multicentre study from Europe [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. The NMSs almost inevitably emerge with disease progression, and they dominate the clinical picture of advanced PD [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. On the other hand, various aspects of these symptoms may exist even prior to the motor manifestations of PD or dominate the clinical picture since the early phase of the disease [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. The evaluation of the NMSs among distinct phases of the disease and the clarification of the clinical correlates of the NMSs contribute substantial topics for further deliberations.\u003c/p\u003e \u003cp\u003eUp to our knowledge, there is no data regarding the prevalence and severity of NMSs in the Turkey cohort. Besides, the clinical burden of NMSs, specifically in newly diagnosed patients, is unclear. We first aimed to investigate the involvement of NMSs in our consecutive PD cohort systematically and reveal the possible clinical correlates. Based on a previous method [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e], we also sought to find out the NMS burden in our cohort. Finally, via our method, our objective was to determine the clinical significance of NMSs across distinct stages of the disease.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eThe study is based on a prospective collection of data from patients diagnosed with PD defined according to Movement Disorders Society clinical diagnostic criteria for PD [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. We enrolled all consecutive PD subjects who applied to our movement disorders outpatient clinics at Etlik City Hospital between January/2023 and December/2023; and accepted to participate in the study. In addition to the evaluation of the demographic and clinical features, we performed comprehensive assessments including scales to evaluate both motor and nonmotor features. To evaluate the disease severity, the Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS) [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e] was performed during the medication \u0026lsquo;off\u0026rsquo; state in all subjects. The scores of the MDS-UPDRS subparts (1, 2, 3, and 4) were also calculated and they were used for further analyses. In addition to the MDS-UPDRS part 1, the nonmotor symptoms scale (NMSS) was performed for a more comprehensive evaluation of the NMSs [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. The classification of patients according to the NMSS in 5 stratified levels of burden were performed, which was recently proposed as non-motor symptoms burden levels (NMSB) [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. To evaluate the possible motor clinical correlated in detail, freezing of gait (FOG) was evaluated using the Freezing of Gait Questionnaire (FOGQ) [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e] in all individuals. The informed consent form has been obtained from every participant. Patients with major comorbidity other than PD that could affect the clinical assessments, those who have dementia (based on the clinical assessments), and those who did not cooperate to the evaluations were excluded. The ethics committee approval for the study was obtained from the clinical research ethics committee unit of Etlik City Hospital.\u003c/p\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eStatistical Analyses\u003c/h2\u003e \u003cp\u003eUnivariate descriptive analyses were used for reporting sample-level demographic and clinical characteristics including the clinical scales. The independent samples\u0026rsquo; two-tailed t-test for normal distribution data or Mann\u0026ndash;Whitney U-test for non-normal data were used to compare the demographic data, clinical features, and clinical scales including all the sub scores of the NMSS, between the tremor-dominant (TD) and akinetic-rigid (AR) subtypes. The correlation analyses were performed to investigate the association between the clinical parameters (Pearson\u0026rsquo;s for parametric distributions and Spearman\u0026rsquo;s for nonparametric distributions), particularly focusing on the NMSS. The comparisons of the clinical features focusing particularly on the NMSs were made between the patient group receiving newly the diagnosis of PD and others. The statistical analyses were performed using IBM SPSS, version 26.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eIn this study, we included 163 PD subjects with a mean age of 63.9\u0026thinsp;\u0026plusmn;\u0026thinsp;10.4 (F/M\u0026thinsp;=\u0026thinsp;27/136). The disease duration was 3.5 (20) y [median (range)]. The median scores of the MDS-UPDRS-1, MDS-UPDRS-2, MDS-UPDRS-3, MDS-UPDRS-4 were 9.5 (range\u0026thinsp;=\u0026thinsp;36), 9 (range\u0026thinsp;=\u0026thinsp;43), 28 (range\u0026thinsp;=\u0026thinsp;91) and 2 (range\u0026thinsp;=\u0026thinsp;17) points, respectively. The median score of the FOGQ was 4 (range\u0026thinsp;=\u0026thinsp;24) points and the median score of the NMSS was 41 points (range 229). The NMS burden levels were mild in 23.9%, moderate in 24.5%, severe in 25.2%, and very severe in 25.2% of the subjects. The subitems with highest scores were sleep/fatigue, mood/cognition, urinary and miscellaneous (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). On the other hand, the most prevalent subitems were related to the sleep/fatigue (85.9%), gastrointestinal tract (77.3%), urinary (75.5%) and miscellaneous (75.5%) domains (Supplementary Table\u0026nbsp;1). The comparisons between the tremor-dominant (TD) and akinetic-rigid (AR) subtypes revealed that the groups were similar in terms of age, gender, and disease duration. Among the clinical scales, only the MDS-UPDRS part 1 scores differed between groups (9 y versus 13 y, p\u0026thinsp;=\u0026thinsp;0.012) (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). Of note, the NMSS sub scores also did not differ between male and female subjects (Supplementary Table\u0026nbsp;2). The correlation analyses between the clinical scales and the NMSS scores revealed positive correlations between the NMSS scores and the results of all the clinical scales including the MDS-UPDRS 1,2, 3, 4, and FOGQ. Besides, the FOGQ scores correlated positively with all motor and non-motor clinical scales (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e). The correlation analyses between the clinical scales and the NMSS sub scores revealed that the MDS-UPDRS 1 scores correlated positively with all the sub scores of the NMSS. On the other hand, there were positive correlations between the motor sub scores and most of the NMSS subitems. Such that, the MDS-UPDRS part 1 scores and the FOGQ scores were found to be correlated with all the subitems of the NMSSS, except the NMSS-attention. The other correlation analyses revealed that only the cardiovascular sub scores showed positive correlation with age. On the other hand, the scores of various NMSS subitems correlated positively with disease duration, including the sleep/fatigue, mood/cognition, perceptual problems/hallucination, gastrointestinal tract, urinary, sexual function, miscellaneous domains (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e). The analyses within the patient group with newly diagnosis of PD also revealed high NMSS scores. Of note, the NMS burden levels were mild in 30.4%, moderate in 32.6%, severe in 21.7%, and very severe in 13.0% of the subjects. The highest three sub scores for NMSS in this group were sleep/fatigue, miscellaneous and urinary sub scores, respectively (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). Remarkably, although the scores regarding the motor severity were all lower in the newly diagnosed group in comparison to those with previous diagnosis, the scores of the various subitems of the NMSS did not differ between groups (Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e "},{"header":"Discussion","content":"\u003cp\u003eWe found that the NMS burden load was severe in a quarter of the groups whereas another quarter of the patients had a very severe NMS burden load. Almost all patients suffered at least from one NMSs. Eighty six percent of the patients suffered from symptoms related to sleep/fatigue complaints and frequency of various other domains of NMSs including gastrointestinal tract, urinary, miscellaneous, and attention/memory was higher than 70% one by one. There rates were higher than in most of the other studies [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. In a recent study by Bugalho et al., the authors investigated the data of 134 consecutive PD subjects and found that sleep/fatigue, affect/cognition, attention/memory were the most frequent complaints among NMSs [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. They noted a prevalence above 80% similar to our results. However, in our group, the domains related to urinary and miscellaneous were more prominent, following the sleep/fatigue subitem. Sahu et al. also found high rates of NMS burden in their PD cohort [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Such that, every patients (n\u0026thinsp;=\u0026thinsp;150) experienced NMS and 90% had more than five NMSs [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. They found that the miscellaneous was the most prevalent domain of NMSS, followed by sleep/fatigue, gastrointestinal tract, and mood/cognition[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Martinez-Martin et al. showed the highest scores in the mood/apathy, sleep/fatigue, urinary, and miscellaneous domains, respectively [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. As understood, there are some variations among studies in this respect [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. Another issue may be related to the specificity of these symptoms to PD pathology and their impact in the QOL indexes of patients. Various recent studies have remarked on the impact of NMSs on QOL indexes of patients [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. Such that, NMSs were reported to exert a stronger influence in QOL indexes than the motor symptoms in a recent two cohort studies from distinct regions [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. In one of these previous studies, mood/apathy was found to have the strongest influence in QOL of PD subjects [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. In the other study on 411 PD subjects [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e], the authors found high correlations between the total NMSS scores and QOL status measured by PDQ-39. Among the subitems, the sleep/fatigue and the mood/apathy showed highest correlations with QOL indexes [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. On the other hand, Karri et al found that almost all the subdomains of NMS except for perceptual, urinary, and sexual domains had shown a stronger correlation with PDQ‑39 score than H and Y stage [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. We found the domains related to miscellaneous, gastrointestinal and urinary symptoms among the prevalent subtypes; however, the domain which was most prevalent and had highest scores was sleep/fatigue. On the other hand, we did not include a quantitative assessment of QOL indexes which avoid us to investigate the differing impact of NMSs in QOL separately. However, in all the individuals, we evaluated the NMS burden levels which were shown to integrate the frequency and severity of NMSs and reflect the disease stage [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAnother critical point of our study was that we also examined the NMSs in the subgroup of newly diagnosed patients. We also compared the presence and severity of these features with the remaining patient group which may provide contribute clinical perspectives. The appearance of NMSS at first presentation may not be apparent, and they are frequently overlooked and untreated [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. Therefore, determining the precise patterns of NMSs incidence in relation to the onset of motor symptoms is critical to understand how the disease evolves and how the NMS contributes to the morbidity of PD subjects leading to hospital admission [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. On the other hand, we know that the NMSs may also be encountered in normal aging subjects [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. However, these symptoms are found to be ubiquitous, more frequent, and more severe in PD subjects in comparison to age-matched controls [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. Particularly, cardiovascular, mood/cognition, and perceptual problems/hallucinations domains were rarely involved in age-matched controls [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. Ergo, the detailed assessment of the NMSs in those with initial diagnosis and previous diagnosis may also provide contributions to our understanding the temporal evolution of the disease and regarding the diagnostic purposes. Of note, the prevalence and severity of NMSs evaluated by NMSS were strictly high in even our newly diagnosed PD subjects. Such that, more than one third of our patients with newly diagnosed PD had a severe-very severe NMS burden load. Besides there was no difference in many of the NMSS sub scores including the cardiovascular, mood/cognition, attention-memory, urinary, and miscellaneous subitems between newly and previous diagnosed groups. However, all the scores of the motor scales were higher in the latter group which might suggest that the NMSs have an apparent clinical impact since the initial phase of the diagnosis. However, we cannot make a definitive conclusion since we did not include a control group. Finally, the diagnostic contribution of NMSs may also be an intriguing issue that needs to be addressed in future-related studies.\u003c/p\u003e \u003cp\u003eOn the other hand, we found that the NMSS total score showed low-moderate correlations with various motor severity scores including the disease duration, the scores of the MDS-UPDRS sub parts, and FOGQ. In the largest cohort published by Chaudhuri KR et al., the authors analysed the data of 935 consecutive PD subjects and found moderate correlations between the motor disturbance ratings (SCOPA-Motor) and the NMSS scores [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. However, they noted that the correlations strengthened in the most advanced stage of the disease. Another study in 2011 by Krishnan et al. reported high correlations between the NMSS scores and the H and Y stage in their study group including 174 PD subjects [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. On the other hand, a more recent study in Indian cohort did not find correlations between the NMSS score and the H and Y stages [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. In the other study conducted in Jordan, the authors revealed that the NMSS did not show a correlation with the age, gender, or disease duration as defined by the classical motor symptoms [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. The discordance between these studies might be related to the motor stages of the patients included which differed between the studies. For instance, patients enrolled in the study by Sahu et al. mostly constituted from those with mild disease stage, and those with Modified H and Y stage 4 or 5 were very rare [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. In our group, the median score for the MDS-UPDRS-3 was 28 and the scores regarding the motor complication section was low (median 2 points) showing rather a population at mild-moderate disease stage. Overall, they also found that total NMSS score increased with increasing duration of disease [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. We also found an increasing NMSS score with increasing disease duration. However, the correlation coefficient was lower (CC:0.330, p\u0026thinsp;=\u0026thinsp;0.00) in comparison to the correlations with motor scales. Of note, the Krishnan et al. found that the NMSs increased with age in controls whereas age had no effect on NMSs in PD subjects [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. In accordance with this, we also did not determine corelation with age or disease onset age. On the other hand, the subgroup analyses revealed only the cardiovascular sub scores showed positive correlation with age. However, the scores of various subitems correlated positively with disease duration, including the sleep/fatigue, mood/cognition, perceptual problems/hallucination, gastrointestinal tract, urinary, sexual function, miscellaneous domains. Remarkably, the cardiovascular domain was among the domains with lowest scores in our cohort; and did not differ between the newly diagnosed and previously diagnosed groups. Therefore, our results may suggest that the cardiovascular domain of the NMSS may not be specific to PD, as it was not a frequent domain, and no association was found with the increasing severity of the disease and duration. Besides, based on our findings of correlations with the NMSS subitems, our results may support the literature data regarding the increased NMS burden with increasing motor stage [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. However, future studies are warranted to clarify the controversies in this regard. Of note, the association between the NMS and FOG which represent a motor phenomenon may constitute another interesting topic of discussion. There is evidence regarding a close association between the FOG and the existence of NMSs including urinary dysfunction, cognitive impairment, hallucinations, and psychosis [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. The association between the cognitive impairment, hallucination and FOG is rather an emphasized issue[\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. We found that all the subitem, except the attention/memory, showed positive correlations with FOGQ scores. However, all of them were low correlations among which the sleep/fatigue and the gastrointestinal tract domain scores had the highest correlations with FOGQ scores.\u003c/p\u003e \u003cp\u003eIn conclusion, we reported the first data regarding the NMS burden in PD subjects from Turkey. In our group constituting of mild-moderate motor disease stage PD subjects, we found high prevalence and severity of various domains of NMSs, most being the sleep/fatigue, mood/cognition, urinary and miscellaneous. More than half of the patients had NMS burden level of severe-very severe. Finally, the occurrence of the NMSs was prevalent even at the subgroup with newly diagnosed patients. Our findings draw attention to the NMSs as cardinal features of PD throughout all the disease stage. The recognition and early identification of these features are surely warranted for optimal diagnosis as well as better clinical outputs.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eMDS-UPDRS; Movement Disorder Society-\u003cem\u003esponsored revision\u003c/em\u003e\u003cem\u003e\u0026nbsp;\u003c/em\u003eof the Unified Parkinson\u0026apos;s Disease Rating Scale, NMSS; Nonmotor symptoms scale (NMSS), FOGQ; Freezing of gait questionnaire.\u0026nbsp;\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eCompliance with ethical standards\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe ethical approval has been obtained from the local committee of the Etlik City Hospital. Informed consent form has been obtained from the patient.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDeclaration of conflict of interest:\u003c/strong\u003e None.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments:\u003c/strong\u003e None.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor Contributions:\u003c/strong\u003e (1) Research project: A. Conception, B. Organisation, C. Execution; (2) Statistical Analysis: A. Design, B. Execution, C. Review and Critique; (3) Manuscript Preparation: A. Writing of the first draft, B. Review and Critique. HO: 1A, 1B, 1C, 3A, 3B; SSC; 1A, 3B.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e: None.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eP. Barone, R. Erro, M. Picillo, Quality of Life and Nonmotor Symptoms in Parkinson's Disease, International review of neurobiology 133 (2017) 499\u0026ndash;516.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eA.M. Sulagna Sahu, Samar Biswas, Valentina Leta, Katarina Rukavina, Shyamal Kumar Das, Atanu Biswas, Burden of nonmotor symptoms in Parkinson\u0026rsquo;s disease patients from eastern India, Annals of Movement Disorders (2021).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eA. Ravan, F.M. Ahmad, S. Chabria, M. Gadhari, C.S. Sankhla, Non-motor symptoms in an Indian cohort of Parkinson's disease patients and correlation of progression of non-motor symptoms with motor worsening, Neurology India 63(2) (2015) 166\u0026ndash;74.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eS. Krishnan, G. Sarma, S. Sarma, A. Kishore, Do nonmotor symptoms in Parkinson's disease differ from normal aging?, Movement disorders: official journal of the Movement Disorder Society 26(11) (2011) 2110\u0026ndash;3.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eP. Martinez-Martin, C. Rodriguez-Blazquez, M.M. Kurtis, K.R. Chaudhuri, The impact of non-motor symptoms on health-related quality of life of patients with Parkinson's disease, Movement disorders: official journal of the Movement Disorder Society 26(3) (2011) 399\u0026ndash;406.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eH.M. Lee, S.B. Koh, Many Faces of Parkinson's Disease: Non-Motor Symptoms of Parkinson's Disease, Journal of movement disorders 8(2) (2015) 92\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eM.J.A.M. Said Salah Dahbour, Liyan H. Oweis, Nada T. Al Antary, Maram Mohsen and Safa Al Fegi, Non\u0026ndash;motor manifestation of Parkinson\u0026rsquo;s disease: a cross\u0026ndash;sectional study in a teaching hospital in Jordan, The Egyptian Journal of Neurology, Psychiatry and Neurosurgery (2022) 58:148.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJ.Y. Lee, S.H. Seo, Y.K. Kim, H.B. Yoo, Y.E. Kim, I.C. Song, J.S. Lee, B.S. Jeon, Extrastriatal dopaminergic changes in Parkinson's disease patients with impulse control disorders, Journal of neurology, neurosurgery, and psychiatry 85(1) (2014) 23\u0026ndash;30.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eK. Ray Chaudhuri, J.M. Rojo, A.H. Schapira, D.J. Brooks, F. Stocchi, P. Odin, A. Antonini, R.G. Brown, P. Martinez-Martin, A proposal for a comprehensive grading of Parkinson's disease severity combining motor and non-motor assessments: meeting an unmet need, PloS one 8(2) (2013) e57221.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eR.B. Postuma, D. Berg, M. Stern, W. Poewe, C.W. Olanow, W. Oertel, J. Obeso, K. Marek, I. Litvan, A.E. Lang, G. Halliday, C.G. Goetz, T. Gasser, B. Dubois, P. Chan, B.R. Bloem, C.H. Adler, G. Deuschl, MDS clinical diagnostic criteria for Parkinson's disease, Movement disorders: official journal of the Movement Disorder Society 30(12) (2015) 1591\u0026thinsp;\u0026ndash;\u0026thinsp;601.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eC.G. Goetz, B.C. Tilley, S.R. Shaftman, G.T. Stebbins, S. Fahn, P. Martinez-Martin, W. Poewe, C. Sampaio, M.B. Stern, R. Dodel, B. Dubois, R. Holloway, J. Jankovic, J. Kulisevsky, A.E. Lang, A. Lees, S. Leurgans, P.A. LeWitt, D. Nyenhuis, C.W. Olanow, O. Rascol, A. Schrag, J.A. 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Korczyn, Construction of freezing of gait questionnaire for patients with Parkinsonism, Parkinsonism \u0026amp; related disorders 6(3) (2000) 165\u0026ndash;170.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eM.K. Chaudhuri JR, Bandaru VS., Prevalence of Non-motor Symptoms in Parkinson\u0026rsquo;s Disease: A Study from South India, Turkish Journal of Neurology 27 (2021) 52\u0026ndash;57.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eM. Karri, B. Ramasamy, R. Kalidoss, Prevalence of Non-motor Symptoms in Parkinson's Disease and Its Impact on Quality of Life in Tertiary Care Center in India, Annals of Indian Academy of Neurology 23(3) (2020) 270\u0026ndash;274.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eP. Bugalho, T. Lampreia, R. Miguel, M.D. Mendon\u0026ccedil;a, A. Caetano, R. Barbosa, Non-Motor symptoms in Portuguese Parkinson's Disease patients: correlation and impact on Quality of Life and Activities of Daily Living, Scientific reports 6 (2016) 32267.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eD.G. Lichter, R.H.B. Benedict, L.A. Hershey, Freezing of Gait in Parkinson's Disease: Risk Factors, Their Interactions, and Associated Nonmotor Symptoms, Parkinson's disease 2021 (2021) 8857204.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eE.B. Forsaa, J.P. Larsen, T. Wentzel-Larsen, G. Alves, A 12-year population-based study of freezing of gait in Parkinson's disease, Parkinsonism \u0026amp; related disorders 21(3) (2015) 254\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"},{"header":"Tables","content":"\u003cdiv class=\"gridtable\"\u003e\n \u003ctable id=\"Tab1\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eThe demographic and clinical characteristics of the overall group (n\u0026thinsp;=\u0026thinsp;163)\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eAge, mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" colspan=\"3\"\u003e\n \u003cp\u003e63.9\u0026thinsp;\u0026plusmn;\u0026thinsp;10.4\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eGender, F/M\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"3\"\u003e\n \u003cp\u003e27/136\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDisease onset side (R/L/Bil)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"3\"\u003e\n \u003cp\u003e83/67/4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDisease subtype, (TD/AR)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"3\"\u003e\n \u003cp\u003e100/56\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRBD, n/%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"3\"\u003e\n \u003cp\u003e53/163 (%32.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAnosmia, n/%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"3\"\u003e\n \u003cp\u003e52/163 (% 31.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eConstipation, n/%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"3\"\u003e\n \u003cp\u003e99/163 (% 60.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNMS burden levels\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"3\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo, 0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"3\"\u003e\n \u003cp\u003e0.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMild, 1\u0026ndash;20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"3\"\u003e\n \u003cp\u003e23.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eModerate, 21\u0026ndash;40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"3\"\u003e\n \u003cp\u003e24.5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSevere, 41\u0026ndash;70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"3\"\u003e\n \u003cp\u003e25.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eVery severe, \u0026ge;\u0026thinsp;70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" colspan=\"3\"\u003e\n \u003cp\u003e25.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMedian (Range)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMean\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eStandard deviation\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDisease duration\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.5 (20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMDS-UPDRS-1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e9.5 (36)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e11.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMDS-UPDRS-2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e9 (43)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e11.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e10.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMDS-UPDRS-3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e28 (91)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e31.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e19.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMDS-UPDRS-4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2 (17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFOGQ\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4 (24)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNMSS total score\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e41 (229)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e51.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e41.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNMSS-cardiovascular\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.0 (18)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNMSS-Sleep/fatigue\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7 (44)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e9.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNMSS-Mood/Cognition\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4 (72)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e9.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e12.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNMSS-Perceptual problems/hallu\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.0 (62)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNMSS-Attention/memory\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3 (36)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNMSS-Gastrointestinal tract\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4 (38)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNMSS-Urinary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4 (36)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNMSS-Sexual function\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.0 (24)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMiscalleneous\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4 (36)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u003cstrong\u003eAbbreviations:\u003c/strong\u003eF/M; Female/Male, TD/AR; Tremor-dominant/Akinetic-rigid, RBD; REM sleep behavior disorder, MDS-UPDRS; MDS-Sponsored Revision of the Unified Parkinson\u0026apos;s Disease Rating Scale, FOGQ; Freezing of gait questionnaire, NMSS; Nonmotor symptom scale.\u003c/p\u003e\n\u003ctable id=\"Tab2\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eComparison of the demographic and clinical features between the tremor-dominant and Akinetic-rigid patient groups.\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eTremor-dominant\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eAkinetic-rigid\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003ep-value\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e68 (49)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e60.5 (43)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.037\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eGender, F/M\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e16/87\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e15/43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.161\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eDisease duration\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3 (19)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4 (17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.370\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMDS-UPDRS-1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e9 (31)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e13 (35)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.012\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMDS-UPDRS-2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e9 (39)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e12 (43)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.286\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMDS-UPDRS-3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e26 (91)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e31 (79)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.436\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMDS-UPDRS-4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0 (15)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3 (17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.182\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFOGQ\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4 (24)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5 (39)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.109\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNMSS total score\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e49 (219)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e45 (228)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.713\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNMSS-cardiovascular\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0 (12)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0 (18)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.442\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNMSS-Sleep/fatigue\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7 (44)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8 (39)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.850\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNMSS-Mood/Cognition\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4 (72)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e7.5 (49)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.537\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNMSS-Perceptual problems/hallucination\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0 (62)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0 (30)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.665\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNMSS-Attention/memory\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3 (36)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.5 (24)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.799\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNMSS-Gastrointestinal tract\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4 (32)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4 (38)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.795\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNMSS-Urinary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4 (36)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5 (36)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.686\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNMSS-Sexual function\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0 (24)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1 (21)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.226\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMiscellaneous\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4 (36)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5 (33)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.222\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003eAbbreviations:\u003c/strong\u003eMDS-UPDRS; MDS-Sponsored Revision of the Unified Parkinson\u0026apos;s Disease Rating Scale, FOGQ; Freezing of gait questionnaire, NMSS; Nonmotor symptom scale.\u003c/p\u003e\n\u003ctable id=\"Tab3\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eThe correlation analyses between the clinical scales within the whole group (n\u0026thinsp;=\u0026thinsp;163).\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eDisease duration\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eMDS-UPDRS-1\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eMDS-UPDRS-2\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eMDS-UPDRS-3\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eMDS-UPDRS-4\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eMDS- UPDRS Total\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eFOGQ\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eNMSS\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e10.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e-0.014\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.103\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.039\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.052\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e-0.231\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e-0.025\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.050\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e-0.005\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.863\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.189\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.617\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.506\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.003\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.748\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.527\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.948\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eDisease onset age\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.901\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e-0.394\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e-0.021\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e-0.147\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e-0.138\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e-0.369\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e-0.219\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e-0.135\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e-0.126\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.787\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.063\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.081\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.005\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.088\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.112\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eDisease duration\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e-0.014\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e10.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.378\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.504\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.513\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.511\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.565\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.471\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.330\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.863\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eMDS- UPDRS-1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.103\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.378\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e10.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.678\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.416\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.396\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.621\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.465\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.563\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.189\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eMDS-UPDRS-2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.039\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.504\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.678\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e10.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.580\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.532\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.767\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.651\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.532\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.617\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eMDS- UPDRS-3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.052\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.513\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.416\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.580\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e10.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.602\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.790\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.597\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.367\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.506\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eMDS- UPDRS-4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e-0.231\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.511\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.396\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.532\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.602\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e10.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.621\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.521\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.393\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.003\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eMDS- UPDRS-Total\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e-0.025\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.565\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.621\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.767\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.790\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.621\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e10.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.678\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.499\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.748\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eFOGQ\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.050\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.471\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.465\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.651\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.597\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.521\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.678\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e10.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.434\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.527\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAbbreviations:\u003c/strong\u003eMDS-UPDRS; MDS-Sponsored Revision of the Unified Parkinson\u0026apos;s Disease Rating Scale, FOGQ; Freezing of gait questionnaire, NMSS; Nonmotor symptom scale.\u003c/p\u003e\n\u003ctable id=\"Tab4\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eThe correlation analyses between the clinical scales and the NMSS sub scores (n\u0026thinsp;=\u0026thinsp;163).\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eNMSS-cardiovascular\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eNMSS-sleep/fatigue\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eNMSS-mood/cognition\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eNMSS-hallucination\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eNMSS-attention/memory\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eNMSS-gastrointestinal\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eNMSS-urinary\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eNMSS-sexual\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eNMSS-miscellaneous\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.163\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e-0.077\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e-0.095\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.046\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e-0.014\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.096\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.153\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e-0.186\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e-0.144\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.038\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.327\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.227\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.557\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.863\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.222\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.051\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.017\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.067\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eDisease onset age\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.166\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e-0.152\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e-0.203\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e-0.066\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e-0.022\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e-0.051\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.096\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e-0.206\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e-0.246\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.035\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.055\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.010\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.409\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.781\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.525\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.227\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.009\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.002\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eDisease duration\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e-0.028\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.182\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.233\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.283\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.044\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.362\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.186\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.243\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.254\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.724\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.020\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.003\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.573\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.017\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.002\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eMDS-UPDRS-1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.198\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.378\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.404\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.331\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.291\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.333\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.448\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.304\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.299\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.011\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eMDS-UPDRS-2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.222\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.406\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.418\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.333\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.130\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.362\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.423\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.275\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.195\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.004\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.098\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.012\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eMDS-UPDRS-3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e-0.008\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.264\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.250\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.271\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.094\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.247\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.269\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.234\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.187\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.919\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.231\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.003\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.017\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eMDS-UPDRS-4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.002\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.262\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.277\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.214\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.088\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.261\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.215\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.313\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.284\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.983\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.006\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.262\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.006\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eMDS-UPDRS-Total\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.052\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.387\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.367\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.344\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.147\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.316\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.345\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.384\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.274\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.510\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.062\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" rowspan=\"2\"\u003e\n \u003cp\u003eFOGQ\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.177\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.352\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.290\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.275\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.096\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.338\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.288\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.217\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.250\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eP\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.023\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.225\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.005\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"char\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003ctfoot\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"11\"\u003eAbbreviations: MDS-UPDRS; MDS-Sponsored Revision of the Unified Parkinson\u0026apos;s Disease Rating Scale, FOGQ; Freezing of gait questionnaire, NMSS; Nonmotor symptom scale.\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tfoot\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n \u003ctable id=\"Tab5\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eThe comparisons of the clinical features and clinical scales between the newly diagnosed patient group and those with previous diagnosis.\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eNewly diagnosis\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003ePatients with previous diagnosis\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eSig.\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAge, median (range)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e66.5 (55)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e64 (45)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.351\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eGender, F/M\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6/40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e21/96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.601\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eRBD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e10/46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e41/117\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.064\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eConstipation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e21/46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e76/117\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.012\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eAnosmia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e13/46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e39/117\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.479\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMDS-UPDRS-1, median (range)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6 (23)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e12 (36)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMDS-UPDRS-2, median (range)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5 (29)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e12 (43)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMDS-UPDRS-3, median (range)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e17 (68)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e33 (86)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMDS-UPDRS-4, median (range)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0 (9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e4 (17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMDS-UPDRS-Total, median (range)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e25 (97)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e56 (140)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eFOGQ, median (range)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2 (14)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5 (24)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNMSS total score, median (range)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e30 (183)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e48.5 (228)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.010\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNMSS-cardiovascular, median (range)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0 (12)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0 (18)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.323\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNMSS-Sleep/fatigue, median (range)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6 (32)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8 (39)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.034\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNMSS-Mood/Cognition, median (range)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1.5 (48)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5.5 (72)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.136\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNMSS-Perceptual problems/hall, median (range)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0 (2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0 (62)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.002\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNMSS-Attention/memory, median (range)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2 (24)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3 (36)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.184\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNMSS-Gastrointestinal tract, median (range)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2 (25)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5 (38)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.008\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNMSS-Urinary, median (range)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3 (36)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6 (36)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.366\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNMSS-Sexual function, median (range)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0 (24)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e1 (24)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.007\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMiscellaneous, median (range)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3.5 (20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5 (36)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0.157\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" colspan=\"4\"\u003e\n \u003cp\u003eNMS burden levels\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo, 0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2.2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" rowspan=\"5\"\u003e\n \u003cp\u003e0.087\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMild,1\u0026ndash;20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e30.4%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e21.9%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eModerate, 21\u0026ndash;40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e32.6%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e21.1%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eSevere, 41\u0026ndash;70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e21.7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e26.3%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eVery severe, \u0026ge;\u0026thinsp;70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e13%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e29.8%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u003cstrong\u003eAbbreviations:\u003c/strong\u003e RBD; REM sleep behavior disorder; MDS-UPDRS; MDS-Sponsored Revision of the Unified Parkinson\u0026apos;s Disease Rating Scale, FOGQ; Freezing of gait questionnaire, NMSS; Nonmotor symptom scale.\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Non‑motor Symptoms, Parkinson’s Disease, Motor Symptoms, Prevalence, Turkey","lastPublishedDoi":"10.21203/rs.3.rs-3915127/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-3915127/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eObjective\u003c/h2\u003e \u003cp\u003eWe aimed to investigate the involvement of non-motor symptoms (NMSs) in our consecutive Parkinson\u0026rsquo;s disease (PD) cohort systematically and reveal the possible clinical correlates.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eWe enrolled all consecutive PD subjects who applied to our movement disorders outpatient clinics between January/2023 and December/2023; and accepted to participate in the study. In addition to the evaluation of the demographic and clinical features, clinical scales, including the MDS-UPDRS, NMSS, and FOOGQ were performed.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eOverall, we enrolled 163 PD subjects with a mean age of 63.9\u0026thinsp;\u0026plusmn;\u0026thinsp;10.4 (F/M\u0026thinsp;=\u0026thinsp;27/136). The disease duration was 3.5 (20) y [median (range)]. The median score of the NMSS was 41 points. The NMSs burden levels were severe in 25.2%, and very severe in 25.2% of the subjects. The subitems with the highest scores were sleep/fatigue, mood/cognition, urinary, and miscellaneous. The correlation analyses between the clinical scales and the NMSS scores revealed positive correlations between the NMSS scores and the results of all the clinical scales including the MDS-UPDRS 1,2, 3, 4, and FOGQ. The analyses within the patient group with newly diagnosed PD also revealed also high NMSS scores.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eWe reported the first data regarding the NMS burden in PD subjects from Turkey. We found a high prevalence and severity of various domains of NMSs, most being sleep/fatigue, mood/cognition, urinary, and miscellaneous. More than half of the patients had an NMS burden of severe to very severe level. We found that NMSs were prevalent even in the subgroup with newly diagnosed patients.\u003c/p\u003e","manuscriptTitle":"Non‑motor Symptoms in Parkinson’s Disease and their clinical correlates: A prevalence study in Tertiary Care Center in Turkey","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-02-05 14:53:32","doi":"10.21203/rs.3.rs-3915127/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"9343decc-291d-4235-8d60-74bc822073b5","owner":[],"postedDate":"February 5th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-03-31T13:44:46+00:00","versionOfRecord":[],"versionCreatedAt":"2024-02-05 14:53:32","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-3915127","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-3915127","identity":"rs-3915127","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}