{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T09:49:31Z","timestamp":1791625771452,"version":"4.3.4"},"reference-count":44,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T00:00:00Z","timestamp":1778716800000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2022YFC3602603"],"award-info":[{"award-number":["2022YFC3602603"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2020\u2010069"],"award-info":[{"award-number":["2020\u2010069"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Brain and Behavior"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Apathy impacts mood and social functioning in patients with Parkinson's disease (PWP), and its effect on motor rehabilitation outcomes remains unexplored.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study evaluates whether the presence of apathy (apathy status) is associated with rehabilitation outcomes in PWP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed records of 122 PWP (Hoehn\u2013Yahr stage \u2264\u00a03) who underwent a 2\u2010week multidisciplinary intensive rehabilitation treatment (MIRT) between April 2020 and July 2024, dividing them into Parkinson's disease with apathy (PDA+, score &gt;\u00a014) and without apathy (PDA\u2212, score \u2264\u00a014) based on Modified Apathy Evaluation Scale (MAES). The outcome measures included the Movement Disorder Society Unified Parkinson's Disease Rating Scale part III (MDS\u2010UPDRS III), the Modified Parkinson Activity Scale (M\u2010PAS), the Five Times Sit to Stand Test (FTSTS), the Timed Up and Go Test (TUG), and the 10\u2010Meter Walk Test (10MWT). We conducted group comparisons and employed multiple linear regression analyses, treating the MAES both as a dichotomous variable and as a continuous predictor. In these analyses, we adjusted for baseline measures of MDS\u2010UPDRS III, FTSTS, and TUG. Additionally, we performed sensitivity analyses using alternative cutoffs (MAES &gt;\u00a013 and &gt;\u00a015).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Following MIRT, the PDA\u2013 group (\n                      <jats:italic>n<\/jats:italic>\n                      = 75) showed significant improvements in MDS\u2010UPDRS III, M\u2010PAS, FTSTS, and TUG (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001,\n                      <jats:italic>p\u00a0<\/jats:italic>\n                      &lt;\u00a00.001,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.011, and\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001, respectively). In contrast, no such improvements were observed in the PDA+ group (\n                      <jats:italic>n<\/jats:italic>\n                      = 47). The improvements in MDS\u2010UPDRS III, FTSTS, and TUG scores exhibited significant differences between the groups (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.018,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.046, and\n                      <jats:italic>p<\/jats:italic>\n                      = 0.042, respectively). In multivariable linear regression with MAES as a continuous variable, higher MAES was independently associated with smaller \u0394MDS\u2010UPDRS III (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      = 0.147, 95% CI 0.017\u20130.277,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.027;\n                      <jats:italic>R<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      = 0.145), after adjustment for baseline MDS\u2010UPDRS III, FTSTS, and TUG. Modeling MAES dichotomously (&gt; 14\u00a0vs. \u2264 14) produced similar results (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      = 2.378, 95% CI 0.341\u20134.415,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.023;\n                      <jats:italic>R<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      = 0.148). Sensitivity analyses using cutoffs of &gt; 13 and &gt; 15 yielded qualitatively comparable findings.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Baseline apathy severity was associated with attenuated motor improvement after MIRT in PWP; understanding its mechanisms is crucial for personalized rehabilitation and treatment effectiveness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>ClinicalTrials.gov identifier: ChiCTR2000033768, 2020\/06\/11<\/jats:p>\n                  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