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Parkinson disease participants (\u201cMotor Only\u201d: <jats:italic>n<\/jats:italic>\u00a0=\u00a061, \u201cPsychiatric &amp; Motor\u201d: <jats:italic>n<\/jats:italic>\u00a0=\u00a017, \u201cCognitive &amp; Motor\u201d: <jats:italic>n<\/jats:italic>\u00a0=\u00a070) and controls (<jats:italic>n<\/jats:italic>\u00a0=\u00a055) completed longitudinal, comprehensive motor, cognitive, and psychiatric evaluations (average follow\u2010up\u00a0=\u00a04.6\u00a0years). Hierarchical linear modeling examined group differences in symptom progression. A three\u2010way interaction among time, group, and symptom duration (or baseline age, separately) was incorporated to examine disease stages.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>All three subtypes increased in motor dysfunction compared to controls. The \u201cMotor Only\u201d subtype did not show significant cognitive or psychiatric changes compared to the other two subtypes. The \u201cCognitive &amp; Motor\u201d subtype\u2019s cognitive dysfunction at baseline further declined compared to the other two subtypes, while also increasing in psychiatric symptoms. The \u201cPsychiatric &amp; Motor\u201d subtype\u2019s elevated psychiatric symptoms at baseline remained steady or improved over time, with mild, steady decline in cognition. The pattern of behavioral changes and analyses for disease staging yielded no evidence for sequential disease stages.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>Parkinson disease clinical subtypes progress in clear, temporally distinct patterns from one another, particularly in cognitive and psychiatric features. This highlights the importance of comprehensive clinical examinations as the order of symptom presentation impacts clinical prognosis.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acn3.51436","type":"journal-article","created":{"date-parts":[[2021,7,26]],"date-time":"2021-07-26T15:09:18Z","timestamp":1627312158000},"page":"1695-1708","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Distinct progression patterns across Parkinson disease clinical subtypes"],"prefix":"10.1002","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2582-691X","authenticated-orcid":false,"given":"Peter S.","family":"Myers","sequence":"first","affiliation":[{"name":"Department of Neurology Washington University School of Medicine St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua J.","family":"Jackson","sequence":"additional","affiliation":[{"name":"Department of Psychological and Brain 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