Moderating effects of uric acid and gender on non-motor symptoms in asymmetric Parkinson's disease

Abstract The interplay between uric acid, gender, and motor symptom asymmetry in the manifestation of non-motor symptomatology (NMS) remains to be better understood in early-stage Parkinson’s disease (PD). A total of 413 patients taking part in the Parkinson’s Progression Marker Initiative were divided into six groups based on their motor symptom asymmetry and gender. Clinical data was extracted over a 5-year follow-up period. Three-way interaction modeling was used to examine the moderating effects of gender and UA in the relationship between motor symptom asymmetry and NMS. The results highlighted significant moderating effects of uric acid on NMS in female PD patients, but not in male PD patients. Furthermore, female patients with right-sided motor symptom onset demonstrated the most preserved NMS functioning in the presence of lower serum uric acid levels, while their male counterparts showed the most impairment. This holds important clinical implications for symptom management in early-stage PD patients.