Impact of motor features on non-motor symptoms in patients with de novo Parkinson's disease: Cognition, depression, anxiety, fatigue, and dysautonomia

Abstract

Aim

Patients with Parkinson's disease (PD) present with both motor and non-motor symptoms, and understanding the interplay between these symptoms is crucial for individualized patient care. This study aims to investigate the relationship between motor features and non-motor symptoms in patients with de novo PD.

Methods

A total of 105 patients were analyzed, focusing on motor subtypes or subscores and their impact on cognition, depression, anxiety, fatigue, and dysautonomia. We utilized the Unified Parkinson's Disease Rating Scale–part III (UPDRS-III) for motor assessment, and various validated scales for non-motor symptoms.

Results

Compared with tremor-dominant (TD) patients, non-TD patients showed severe scores in fatigue and dysautonomia, but no difference in other non-motor symptoms, including global cognition, depression, and anxiety. Linear regression analysis revealed that the total motor score of UPDRS-III was negatively related to global cognition (β = −0.4454, P = 0.0121). As a post-hoc analysis, partial correlation analysis showed that rigidity and bradykinesia subscores were associated with global cognition (r = −0.3527, P = 0.0004; r = −0.2206, P = 0.0299, respectively), whereas the postural instability/gait difficulty subscore was associated with depression, anxiety, fatigue, and dysautonomia (r = 0.2181, P = 0.0319; r = 0.2371, P = 0.0194; r = 0.3659, P = 0.0002; r = 0.3968, P = 0.0001, respectively) but not with global cognition.

Conclusions

These results suggest that motor features in the early stages of PD can serve as important indicators of non-motor symptoms, potentially guiding more personalized therapeutic approaches. Geriatr Gerontol Int 2025; 25: 392–397.