{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T20:45:56Z","timestamp":1790282756036,"version":"4.1.0"},"reference-count":30,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T00:00:00Z","timestamp":1768348800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T00:00:00Z","timestamp":1768348800000},"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 Disorders"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Autonomic dysfunction is a known contributor to cognitive impairment in Parkinson's disease (PD), but its impact during prodromal stage is unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The aim was to determine whether early autonomic burden predicts incident cognitive impairment in prodromal PD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed data from Parkinson's Progression Markers Initiative participants. Autonomic dysfunction was defined as Scales for Outcomes in Parkinson's Disease Autonomic Dysfunction score \u226513, documented prior to phenoconversion. Cox regression assessed the predictors of cognitive impairment, and mixed\u2010effects analysis of variance compared domain\u2010specific cognitive trajectories.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Data on 382 participants were analyzed. Early autonomic dysfunction was significantly associated with increased risk of mild cognitive impairment or dementia (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001), especially in semantic fluency and letter\u2010number sequencing. Cardiovascular autonomic burden, specifically, was a strong independent predictor (HR\u2009=\u20095.21,\n                      <jats:italic>P<\/jats:italic>\n                      =\u20090.01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      Autonomic dysfunction in prodromal PD is a risk factor for cognitive decline, providing opportunity for early risk stratification and intervention. \u00a9 2026 The Author(s).\n                      <jats:italic>Movement Disorders<\/jats:italic>\n                      published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/mds.70202","type":"journal-article","created":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T09:37:50Z","timestamp":1768383470000},"page":"1299-1303","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Early Autonomic Burden in Prodromal Parkinson's Disease Predicts Cognitive Impairment"],"prefix":"10.1002","volume":"41","author":[{"given":"A. Enrique","family":"Martinez\u2010Nunez","sequence":"first","affiliation":[{"name":"Norman Fixel Institute for Neurological Diseases University of Florida  Gainesville Florida 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"}]},{"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"}]},{"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":"Gregory M.","family":"Pontone","sequence":"additional","affiliation":[{"name":"Norman Fixel Institute for Neurological Diseases University of Florida  Gainesville Florida USA"},{"name":"Department of Psychiatry and Behavioral Sciences Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8807-6672","authenticated-orcid":false,"given":"Abhimanyu","family":"Mahajan","sequence":"additional","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"}]}],"member":"311","published-online":{"date-parts":[[2026,1,14]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.26632"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000213470"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000201659"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/ene.13919"},{"issue":"12","key":"e_1_2_10_6_1","first-page":"1215","article-title":"Using prodromal non\u2010motor symptoms to predict Parkinson's disease onset and motor phenotype","volume":"96","author":"Pearson J","year":"2025","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"e_1_2_10_7_1","unstructured":"Initiative P.s.P.M.PPMI Study Cohorts;2025.https:\/\/www.ppmi-info.org\/study-design\/study-cohorts."},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/acn3.644"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.26424"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.30044"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/mdc3.70100"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.25170"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.24893"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41531-025-00874-8"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2021.117999"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41593-018-0234-x"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/mdc3.14017"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.124.23188"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.2174\/157015908785777229"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.3758\/s13421-022-01314-1"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1080\/23279095.2014.992069"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/hbm.20033"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11682-022-00698-7"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000002001"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1093\/cercor\/bhab249"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2023.10.002"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.20153"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10286-007-0410-7"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.autneu.2025.103258"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.prdoa.2023.100191"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1093\/braincomms\/fcaf310"}],"container-title":["Movement Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/movementdisorders.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mds.70202","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/movementdisorders.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/mds.70202","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/movementdisorders.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mds.70202","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T10:06:08Z","timestamp":1779789968000},"score":1,"resource":{"primary":{"URL":"https:\/\/movementdisorders.onlinelibrary.wiley.com\/doi\/10.1002\/mds.70202"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,14]]},"references-count":30,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1002\/mds.70202"],"URL":"https:\/\/doi.org\/10.1002\/mds.70202","archive":["Portico"],"relation":{},"ISSN":["0885-3185","1531-8257"],"issn-type":[{"value":"0885-3185","type":"print"},{"value":"1531-8257","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,14]]},"assertion":[{"value":"2025-09-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-05","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-14","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}