{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T10:04:33Z","timestamp":1790071473109,"version":"4.0.1"},"reference-count":48,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T00:00:00Z","timestamp":1774569600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T00:00:00Z","timestamp":1774569600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["movementdisorders.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Movement Disord Clin Pract"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Non\u2010motor symptoms, especially autonomic dysfunction, are major contributors to disability and decreased quality of life in Parkinson's disease (PD). Despite being common and having a wide range of clinical facets, exocrine gland dysfunction is still not well recognized and managed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The aim of this narrative review is to present a thorough and integrative synthesis of exocrine gland dysfunction in PD, including an overview of its underlying mechanisms, clinical manifestations, diagnostic techniques, and treatment approaches.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We critically reviewed the literature addressing autonomic regulation of exocrine glands, \u03b1\u2010synuclein pathology in central and peripheral autonomic networks, and clinical studies of glandular dysfunction across salivary, lacrimal, sebaceous, nasal, sweat, gastric, and pancreatic systems in PD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Exocrine dysfunction in PD is multifaceted and potentially linked to degeneration within central autonomic control regions, peripheral autonomic nerves, and even glandular tissues themselves, often compounded by iatrogenic medication effects. Importantly, certain disturbances may precede motor features, underscoring their potential as prodromal markers. Clinically, such dysfunctions significantly impair different aspects of health and well\u2010being overall. Multidisciplinary approach is needed for management, striking a balance between symptom relief and consideration of treatment\u2010related tradeoffs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Exocrine gland dysfunction represents a prevalent, intricate, and clinically significant range of non\u2010motor symptoms in PD, indicative of extensive autonomic involvement. Early detection may enhance quality of life and symptom management while also offering insights into disease mechanisms, the discovery of biomarkers and therapeutic interventions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/mdc3.70610","type":"journal-article","created":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T06:15:03Z","timestamp":1774678503000},"page":"2081-2092","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Exocrine Gland Dysfunction in Parkinson's Disease: Pathophysiology, Clinical Manifestations, and Therapeutic Perspectives\u2014A Narrative Review"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4783-4067","authenticated-orcid":false,"given":"Renato P.","family":"Munhoz","sequence":"first","affiliation":[{"name":"Morton and Gloria Shulman Movement Disorders Centre and the Edmond J. Safra Program in Parkinson's Disease, Toronto Western Hospital University Health Network  Toronto Ontario Canada"},{"name":"Krembil Research Institute  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina","family":"Farah","sequence":"additional","affiliation":[{"name":"Cajuru University Hospital Pontifical Catholic University of Paran\u00e1  Curitiba Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Silveira\u2010Moriyama","sequence":"additional","affiliation":[{"name":"Department of Neurology UNICAMP  Campinas Brazil"},{"name":"Honorary Clinical Lecturer, Teaching Unit UCL Institute of Neurology  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,27]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.51.6.745"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(06)70373-8"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1590\/0004-282X20150029"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/j.2040-4603.2014.tb00557.x"},{"issue":"2","key":"e_1_2_10_6_1","first-page":"103","article-title":"Autonomic dysfunction in Parkinson's disease: mechanisms and clinical features","volume":"30","author":"Patel M","year":"2020","journal-title":"Clin Auton Res"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nbd.2011.10.014"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)61393-3"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nbd.2011.10.026"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1212\/CON.0000000000000817"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2011.09.030"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3182a9f449"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0197-4580(02)00065-9"},{"issue":"4","key":"e_1_2_10_14_1","first-page":"457","article-title":"Sudomotor function in Parkinson's disease","volume":"19","author":"Hauser RA","year":"2004","journal-title":"Mov Disord"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13311-020-00897-4"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13024-023-00676-7"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.3390\/biology8020038"},{"key":"e_1_2_10_18_1","first-page":"17","article-title":"Sialorrhea in Parkinson's disease: an update","volume":"38","author":"Jost WH","year":"2017","journal-title":"Parkinsonism Relat Disord"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2014.08.013"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare10030516"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/ger.12628"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.20471\/acc.2022.61.02.19"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.WNL.0000101713.81253.4C"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.21730"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40135-024-00326-1"},{"issue":"9","key":"e_1_2_10_26_1","first-page":"1359","article-title":"Assessing dry eye in Parkinson's disease","volume":"21","author":"Kleiner\u2010Fisman G","year":"2006","journal-title":"Mov Disord"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.1960-18"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-022-22037-y"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2023.1236366"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/jocd.14160"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/dth.14695"},{"key":"e_1_2_10_32_1","first-page":"220","article-title":"Seborrhea and seborrheic dermatitis in Parkinson's disease","volume":"376","author":"Knudsen K","year":"2017","journal-title":"J Neurol Sci"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1002\/mdc3.12425"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.4103\/1673-5374.387967"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.3988\/jcn.2022.18.6.628"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2016.08.015"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.3205\/cto000071"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1212\/CPJ.0000000000001180"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2021.09.012"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.15808"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000013300"},{"key":"e_1_2_10_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2023.105489"},{"key":"e_1_2_10_43_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.21422"},{"key":"e_1_2_10_44_1","doi-asserted-by":"publisher","DOI":"10.1002\/da.22680"},{"key":"e_1_2_10_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpg.2016.02.007"},{"issue":"2","key":"e_1_2_10_46_1","first-page":"S749","article-title":"Exocrine pancreatic insufficiency in Parkinson's disease","volume":"34","author":"Gabrovska M","year":"2019","journal-title":"Mov Disord"},{"key":"e_1_2_10_47_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.20153"},{"key":"e_1_2_10_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2011.02.011"},{"key":"e_1_2_10_49_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.23875"}],"container-title":["Movement Disorders Clinical Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/movementdisorders.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mdc3.70610","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/movementdisorders.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/mdc3.70610","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/movementdisorders.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mdc3.70610","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T09:18:37Z","timestamp":1790068717000},"score":1,"resource":{"primary":{"URL":"https:\/\/movementdisorders.onlinelibrary.wiley.com\/doi\/10.1002\/mdc3.70610"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,27]]},"references-count":48,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1002\/mdc3.70610"],"URL":"https:\/\/doi.org\/10.1002\/mdc3.70610","archive":["Portico"],"relation":{},"ISSN":["2330-1619","2330-1619"],"issn-type":[{"value":"2330-1619","type":"print"},{"value":"2330-1619","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,27]]},"assertion":[{"value":"2025-09-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-14","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-27","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}