{"doi":"10.1111/ene.13803","title":"Non‐motor symptoms in early Parkinson's disease with different motor subtypes and their associations with quality of life","abstract":"<jats:sec><jats:title>Background and purpose</jats:title><jats:p>The aim of this study was to examine non‐motor symptoms in different Parkinson's disease (<jats:styled-content style=\"fixed-case\">PD</jats:styled-content>) motor subtypes and their associations with quality of life (QoL).</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>A total of 132 patients with early <jats:styled-content style=\"fixed-case\">PD</jats:styled-content> with comprehensive motor examinations and non‐motor symptom assessments were included. Motor subtypes were classified based on Stebbins’ method. Non‐motor symptoms were assessed by the Non‐Motor Symptom Scale (<jats:styled-content style=\"fixed-case\">NMSS</jats:styled-content>) and validated by more comprehensive instruments, including the Pittsburgh Sleep Quality Index (<jats:styled-content style=\"fixed-case\">PSQI</jats:styled-content>) and Fatigue Severity Scale (<jats:styled-content style=\"fixed-case\">FSS</jats:styled-content>). QoL was measured by the Parkinson's Disease Questionnaire‐8.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>We identified 66 patients (50%) with tremor‐dominant (<jats:styled-content style=\"fixed-case\">TD</jats:styled-content>) subtype, 47 (35.6%) with postural instability and gait disorder (<jats:styled-content style=\"fixed-case\">PIGD</jats:styled-content>) subtype and 19 (14.4%) with Intermediate subtype. By comparing <jats:styled-content style=\"fixed-case\">NMSS</jats:styled-content> scores, patients with the <jats:styled-content style=\"fixed-case\">PIGD</jats:styled-content> subtype had more severe sleep impairment and fatigue (domain 2 score: 5.64 vs. 2.52, <jats:italic>P</jats:italic> &lt; 0.001), urinary symptoms (domain 7 score: 6.96 vs. 3.48, <jats:italic>P</jats:italic> = 0.005) and overall more severe non‐motor symptoms (<jats:styled-content style=\"fixed-case\">NMSS</jats:styled-content> total score: 25.89 vs. 17.27, <jats:italic>P</jats:italic> = 0.031), compared with patients with the <jats:styled-content style=\"fixed-case\">TD</jats:styled-content> subtype. Validation using the <jats:styled-content style=\"fixed-case\">PSQI</jats:styled-content> and <jats:styled-content style=\"fixed-case\">FSS</jats:styled-content> again suggested that patients with the <jats:styled-content style=\"fixed-case\">PIGD</jats:styled-content> subtype had independently and significantly more severe sleep impairment (<jats:styled-content style=\"fixed-case\">PSQI</jats:styled-content> score: 5.57 vs. 4.29, <jats:italic>P</jats:italic> = 0.020) and fatigue (<jats:styled-content style=\"fixed-case\">FSS</jats:styled-content> score: 34.81 vs. 25.85, <jats:italic>P</jats:italic> = 0.003) compared with patients with the <jats:styled-content style=\"fixed-case\">TD</jats:styled-content> subtype. Several non‐motor symptoms had significant associations with QoL, among which sleep impairment and fatigue (<jats:italic>P</jats:italic> &lt; 0.0001, partial <jats:italic>r</jats:italic><jats:sup>2</jats:sup> = 0.273) explained the largest proportion of QoL variability in patients with <jats:styled-content style=\"fixed-case\">PD</jats:styled-content>.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Patients with the PIGD subtype had more severe sleep impairment, fatigue and urinary disturbance compared with patients with the <jats:styled-content style=\"fixed-case\">TD</jats:styled-content> subtype. Sleep impairment and fatigue were the most important factors affecting QoL independent of motor subtypes. Prompt identification and treatment of these non‐motor symptoms may improve patients’ QoL.</jats:p></jats:sec>","journal":"European Journal of Neurology","year":2019,"id":678003,"datarank":0.6814942173405006,"base_score":4.543294782270004,"endowment":4.543294782270004,"self_citation_contribution":0.6814942173405006,"citation_network_contribution":0.0,"self_endowment_contribution":0.6814942173405006,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":93,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1771496,"name":"S. Y.‐E. Ng","orcid":null,"position":1,"is_corresponding":false},{"id":1771498,"name":"N. S.‐Y. Chia","orcid":null,"position":2,"is_corresponding":false},{"id":1771501,"name":"F. Setiawan","orcid":null,"position":3,"is_corresponding":false},{"id":1771503,"name":"K.‐Y. Tay","orcid":null,"position":4,"is_corresponding":false},{"id":1771505,"name":"W.‐L. Au","orcid":null,"position":5,"is_corresponding":false},{"id":1771508,"name":"E.‐K. Tan","orcid":null,"position":6,"is_corresponding":false},{"id":1771510,"name":"L. C.‐S. Tan","orcid":null,"position":7,"is_corresponding":false},{"id":540108,"name":"X. Huang","orcid":"0000-0002-6695-5606","position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Non‐motor symptoms in early Parkinson's disease with different motor subtypes and their associations with quality of life","abstract":"<jats:sec><jats:title>Background and purpose</jats:title><jats:p>The aim of this study was to examine non‐motor symptoms in different Parkinson's disease (<jats:styled-content style=\"fixed-case\">PD</jats:styled-content>) motor subtypes and their associations with quality of life (QoL).</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>A total of 132 patients with early <jats:styled-content style=\"fixed-case\">PD</jats:styled-content> with comprehensive motor examinations and non‐motor symptom assessments were included. Motor subtypes were classified based on Stebbins’ method. Non‐motor symptoms were assessed by the Non‐Motor Symptom Scale (<jats:styled-content style=\"fixed-case\">NMSS</jats:styled-content>) and validated by more comprehensive instruments, including the Pittsburgh Sleep Quality Index (<jats:styled-content style=\"fixed-case\">PSQI</jats:styled-content>) and Fatigue Severity Scale (<jats:styled-content style=\"fixed-case\">FSS</jats:styled-content>). QoL was measured by the Parkinson's Disease Questionnaire‐8.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>We identified 66 patients (50%) with tremor‐dominant (<jats:styled-content style=\"fixed-case\">TD</jats:styled-content>) subtype, 47 (35.6%) with postural instability and gait disorder (<jats:styled-content style=\"fixed-case\">PIGD</jats:styled-content>) subtype and 19 (14.4%) with Intermediate subtype. By comparing <jats:styled-content style=\"fixed-case\">NMSS</jats:styled-content> scores, patients with the <jats:styled-content style=\"fixed-case\">PIGD</jats:styled-content> subtype had more severe sleep impairment and fatigue (domain 2 score: 5.64 vs. 2.52, <jats:italic>P</jats:italic> &lt; 0.001), urinary symptoms (domain 7 score: 6.96 vs. 3.48, <jats:italic>P</jats:italic> = 0.005) and overall more severe non‐motor symptoms (<jats:styled-content style=\"fixed-case\">NMSS</jats:styled-content> total score: 25.89 vs. 17.27, <jats:italic>P</jats:italic> = 0.031), compared with patients with the <jats:styled-content style=\"fixed-case\">TD</jats:styled-content> subtype. Validation using the <jats:styled-content style=\"fixed-case\">PSQI</jats:styled-content> and <jats:styled-content style=\"fixed-case\">FSS</jats:styled-content> again suggested that patients with the <jats:styled-content style=\"fixed-case\">PIGD</jats:styled-content> subtype had independently and significantly more severe sleep impairment (<jats:styled-content style=\"fixed-case\">PSQI</jats:styled-content> score: 5.57 vs. 4.29, <jats:italic>P</jats:italic> = 0.020) and fatigue (<jats:styled-content style=\"fixed-case\">FSS</jats:styled-content> score: 34.81 vs. 25.85, <jats:italic>P</jats:italic> = 0.003) compared with patients with the <jats:styled-content style=\"fixed-case\">TD</jats:styled-content> subtype. Several non‐motor symptoms had significant associations with QoL, among which sleep impairment and fatigue (<jats:italic>P</jats:italic> &lt; 0.0001, partial <jats:italic>r</jats:italic><jats:sup>2</jats:sup> = 0.273) explained the largest proportion of QoL variability in patients with <jats:styled-content style=\"fixed-case\">PD</jats:styled-content>.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Patients with the PIGD subtype had more severe sleep impairment, fatigue and urinary disturbance compared with patients with the <jats:styled-content style=\"fixed-case\">TD</jats:styled-content> subtype. Sleep impairment and fatigue were the most important factors affecting QoL independent of motor subtypes. Prompt identification and treatment of these non‐motor symptoms may improve patients’ QoL.</jats:p></jats:sec>","is_dataset_classified":null,"base_score":4.543294782270004,"endowment":4.543294782270004,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"30175887","pmcid":null,"openalex_id":"https://openalex.org/W2889914444","authors":[],"funders":[{"funder_name":"National Research Foundation Singapore","grant_id":"TCR12dec010","title":null}],"total_grants":1,"fwci":7.3222,"citation_percentile":0.97828422,"influential_citations":0,"citation_trend":[{"year":2018,"count":1},{"year":2019,"count":21},{"year":2020,"count":13},{"year":2021,"count":12},{"year":2022,"count":15},{"year":2023,"count":14},{"year":2024,"count":10},{"year":2025,"count":4},{"year":2026,"count":3}],"oa_status":"closed","license":"http://onlinelibrary.wiley.com/termsAndConditions#vor","oa_locations":[{"url":"https://api.wiley.com/onlinelibrary/tdm/v1/articles/10.1111%2Fene.13803","host_type":"publisher"},{"url":"https://onlinelibrary.wiley.com/doi/pdf/10.1111/ene.13803","host_type":"publisher"},{"url":"https://onlinelibrary.wiley.com/doi/full-xml/10.1111/ene.13803","host_type":"publisher"},{"url":"https://doi.org/10.1111/ene.13803","host_type":"journal"},{"url":"https://pubmed.ncbi.nlm.nih.gov/30175887","host_type":"repository"},{"url":"http://scholarbank.nus.edu.sg/handle/10635/148985","host_type":"repository"}],"fields_of_study":["Parkinson's Disease Mechanisms and Treatments","Restless Legs Syndrome Research","Balance, Gait, and Falls Prevention"],"mesh_terms":["Aged","Fatigue","Female","Humans","Longitudinal Studies","Male","Middle Aged","Parkinson Disease","Quality of Life","Sleep Wake Disorders"],"keywords":["Medicine","Parkinson's disease","Pittsburgh Sleep Quality Index","Quality of life (healthcare)","Motor symptoms","Internal medicine","Postural instability","Disease","Physical therapy","Sleep quality","Psychiatry","Insomnia","Fatigue","Non-motor Symptoms","Motor Subtypes","Early Parkinson's Disease","Sleep Impairment","Tremor-dominant","Postural Instability/gait Difficulty"],"sdg_mappings":[{"sdg_number":0,"sdg_label":"Good health and well-being"}],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-17T04:49:16.070150Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}