ArticleMovement disorders : official journal of the Movement Disorder Society2026
Greater Motor and Nonmotor Burden at Diagnosis Is Associated With Amyloid Copathology in Parkinson's Disease.
Article in Movement disorders : official journal of the Movement Disorder Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundConcurrent Alzheimer's disease pathology is increasingly recognized as a poor prognostic factor in Parkinson's disease (PD), yet reliable clinical indicators for early identification of AD copathology remain poorly established.
objectiveTo investigate baseline motor and nonmotor symptom profiles associated with amyloid-β (Aβ) copathology in newly diagnosed PD.
methodsAmong patients with PD who underwent Aβ imaging, we retrospectively identified 152 patients who completed the Cross-Cultural Smell Identification Test (CC-SIT), autonomic function tests, neuropsychological assessment, and Neuropsychiatric Inventory Questionnaire (NPI-Q) at drug-naive state. Predictors of Aβ positivity were identified using stepwise multivariable logistic regression and validated with Random Forest classifiers employing Boruta feature selection.
resultsCompared with Aβ-negative counterparts (n = 93), Aβ-positive (Aβ + PD, n = 59) patients demonstrated greater olfactory dysfunction (CC-SIT, P = 0.002), dysautonomia (Composite Autonomic Severity Scale [CASS], P < 0.001), and mood disturbance (NPI-Q-mood, P < 0.001) and higher prevalence of probable rapid eye movement sleep behavior disorder (P = 0.009) and neurogenic orthostatic hypotension (P = 0.006). Aβ + PD patients showed greater motor disability (Unified Parkinson's Disease Rating Scale Part III [UPDRS-III], P < 0.001) despite comparable striatal dopamine transporter uptake. Logistic regression identified lower CC-SIT scores (odds ratio [OR] = 0.821, 95% confidence interval [CI
conclusionsOur findings suggest that greater motor and nonmotor symptom burden at diagnosis, characterized by olfactory/autonomic dysfunction, mood disturbance, and motor deficits disproportionate to dopaminergic denervation, was associated with Aβ positivity in PD. © 2026 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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