{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T20:46:04Z","timestamp":1790282764265,"version":"4.1.0"},"reference-count":40,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,4,25]],"date-time":"2025-04-25T00:00:00Z","timestamp":1745539200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,4,25]],"date-time":"2025-04-25T00:00:00Z","timestamp":1745539200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K23 AG044441\u201001A1"],"award-info":[{"award-number":["K23 AG044441\u201001A1"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["movementdisorders.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Movement Disord Clin Pract"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Non\u2010motor fluctuations, characterized by variability in mood and cognition, are prevalent in advanced Parkinson's disease (PD), but less is known about these fluctuations in early PD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The objective was to characterize fluctuations in cognition and mood in early PD without cognitive impairment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Individuals with PD but without cognitive impairment were evaluated \u201con\u201d and \u201coff\u201d dopaminergic medications for minimal clinically important differences (MCID) in depression, anxiety, and cognition. Multivariable logistic regression evaluated factors associated with medication\u2010related fluctuations in anxiety, depression, and cognition.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Clinically meaningful fluctuations in anxiety were associated with dysautonomia (OR [odds ratio] 7.5) and female sex (OR 3.9). Fluctuations in Symbol Digit Modalities Test (SDMT), a measure of processing speed and executive function, were associated with dysautonomia (OR 2.82). Such an association was not found with depression or Stroop test.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Dysautonomia may influence fluctuations in anxiety and some aspects of cognition in cognitively unimpaired PD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/mdc3.70100","type":"journal-article","created":{"date-parts":[[2025,4,25]],"date-time":"2025-04-25T05:36:06Z","timestamp":1745559366000},"page":"1609-1614","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Investigating Dopamine Replacement\u2013Associated Fluctuations in Cognition and Mood in Cognitively Unimpaired Parkinson's Disease"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8807-6672","authenticated-orcid":false,"given":"Abhimanyu","family":"Mahajan","sequence":"first","affiliation":[{"name":"James J. and Joan A. Gardner Family Center For Parkinson's Disease and Movement Disorders University of Cincinnati  Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher B.","family":"Morrow","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Seemiller","sequence":"additional","affiliation":[{"name":"Department of Neurology Pennsylvania State University\u2010Milton S. Hershey Medical Center  Hershey Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4302-1501","authenticated-orcid":false,"given":"Kelly A.","family":"Mills","sequence":"additional","affiliation":[{"name":"Department of Neurology Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9540-6913","authenticated-orcid":false,"given":"Gregory M.","family":"Pontone","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences Johns Hopkins University School of Medicine  Baltimore Maryland USA"},{"name":"Division of Aging, Behavioral and Cognitive (ABC) Neurology, Department of Neurology University of Florida  Gainesville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,4,25]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.49.10.1182"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/107.2.487"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.26731"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(06)70521-X"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awu195"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/mdc3.13520"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e318285c0ed"},{"key":"e_1_2_9_9_1","unstructured":"NIHreporter.Anxiety in Parkinson's: Use of quantitative methods to guide rational treatment;2014. 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