{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T21:40:11Z","timestamp":1789594811143,"version":"build-2803163510"},"reference-count":28,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2016,2,11]],"date-time":"2016-02-11T00:00:00Z","timestamp":1455148800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Movement Disorders"],"published-print":{"date-parts":[[2016,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Ten to fifteen percent of Parkinson's disease (PD) patients recruited to clinical trials have scans without evidence of dopaminergic deficit, whose presence represents a heterogeneous patient population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A cohort of 41 patients with parkinsonism and scans without evidence of dopaminergic deficit at baseline, were subdivided into groups according to their final clinical diagnoses and nigrostriatal dopamine function assessed after 2 years of study. At follow up, 23 patients had clinically probable PD or unclassified parkinsonism with normal nigrostriatal dopamine imaging (\u201ctrue\u201d scans without evidence of dopaminergic deficit), nine were diagnosed with another tremulous condition, five had psychogenic parkinsonism, and four had phenoconverted to PD with reduced nigrostriatal dopamine function. We analyzed nonmotor symptoms at baseline and follow\u2010up in subgroups of patients with scans without evidence of dopaminergic deficit in comparison with a random sample of 62 PD patients and 195 healthy controls (HCs). All patients were enrolled in the Parkinson's Progressive Marker's Initiative.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Patients who had true scans without evidence of dopaminergic deficit had more severe rapid eye movement sleep disorder, depression, anxiety, and autonomic dysfunction than HCs in addition to more frequent depressive symptoms and worse cardiovascular dysfunction than patients with PD (<jats:italic>P<\/jats:italic>\u2009=\u20090.038, <jats:italic>P<\/jats:italic>\u2009=\u20090.047, respectively). Patients with true scans without evidence of dopaminergic deficit had normal olfaction that was significantly better than that of patients with PD (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001). Subgroup analysis of the cohort with scans without evidence of dopaminergic deficit revealed that all patients shared similar nonmotor features irrespective of their final clinical diagnoses. Follow\u2010up of subject groups showed stable nonmotor symptoms over 2 years of study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>At an early symptomatic stage, patients with scans without evidence of dopaminergic deficit and long\u2010standing parkinsonism exhibit nonmotor features that differ from those of patients with PD on mood and cardiovascular and olfactory function, but remain similar to patients with scans without evidence of dopaminergic deficit with alternative final diagnoses. \u00a9 2016 International Parkinson and Movement Disorder Society<\/jats:p><\/jats:sec>","DOI":"10.1002\/mds.26456","type":"journal-article","created":{"date-parts":[[2016,2,11]],"date-time":"2016-02-11T19:55:40Z","timestamp":1455220540000},"page":"344-351","source":"Crossref","is-referenced-by-count":28,"title":["Progression of nonmotor symptoms in subgroups of patients with non\u2013dopamine\u2010deficient Parkinsonism"],"prefix":"10.1002","volume":"31","author":[{"given":"Stuart","family":"Taylor","sequence":"first","affiliation":[{"name":"Division of Brain Sciences Imperial College London  UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Gafton","sequence":"additional","affiliation":[{"name":"Division of Brain Sciences Imperial College London  UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bina","family":"Shah","sequence":"additional","affiliation":[{"name":"Division of Brain Sciences Imperial College London  UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gennaro","family":"Pagano","sequence":"additional","affiliation":[{"name":"Division of Brain Sciences Imperial College London  UK"},{"name":"Department of Medicine and Health Sciences, School of Medicine University of Molise Campobasso Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K. Ray","family":"Chaudhuri","sequence":"additional","affiliation":[{"name":"Kings' College London and Parkinson's Centre of Excellence Kings College Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J.","family":"Brooks","sequence":"additional","affiliation":[{"name":"Division of Brain Sciences Imperial College London  UK"},{"name":"Department of Clinical Medicine Centre for Functionally Integrative Neuroscience University of Aarhus  Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Pavese","sequence":"additional","affiliation":[{"name":"Division of Brain Sciences Imperial College London  UK"},{"name":"Department of Clinical Medicine Centre for Functionally Integrative Neuroscience University of Aarhus  Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,2,11]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000000424"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.23684"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.23019"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.21685"},{"key":"e_1_2_8_6_1","first-page":"30","article-title":"SWEDD for the General Neurologist","volume":"10","author":"Bajaj N","year":"2010","journal-title":"Adv Clin Neurosci Rehabil"},{"key":"e_1_2_8_7_1","article-title":"Comparison of sleep and other non\u2010motor symptoms between SWEDDs patients and de novo Parkinson's disease patients","author":"Yang H\u2010J","journal-title":"Parkinsonism Relat Disord"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.2009.172825"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.26204"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/14.6.540"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.21740"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1300\/J018v05n01_09"},{"key":"e_1_2_8_13_1","first-page":"292","volume-title":"The Use of Psychological Testing for Treatment Planning and Outcome Assessment","author":"Spielberger CD","year":"1994"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.20153"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.22340"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-198402000-00004"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.25438"},{"key":"e_1_2_8_18_1","first-page":"260","article-title":"Screening, detection and management of depression in elderly primary care attenders. I: The acceptability and performance of the 15 item Geriatric Depression Scale (GDS15) and the development of short versions","volume":"11","author":"D'Ath P","year":"1994","journal-title":"Fam Pract [cited 2014 Month 07]."},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/hcq142"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.26018"},{"key":"e_1_2_8_21_1","first-page":"56","article-title":"Diagnoses behind patients with hard\u2010to\u2010classify tremor and normal DaT\u2010SPECT: a clinical follow up study","volume":"6","author":"Men\u00e9ndez\u2010Gonz\u00e1lez M","year":"2014","journal-title":"Front Aging Neurosci"},{"key":"e_1_2_8_22_1","first-page":"387","article-title":"Occurrence and clinical correlates of REM sleep behaviour disorder in patients with Parkinson's disease over time","volume":"79","author":"Gjerstad MD","year":"2008","journal-title":"J Neurol Neurosurg Psychiatry [Internet]. 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