{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T18:51:35Z","timestamp":1793040695835,"version":"4.5.0"},"reference-count":31,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T00:00:00Z","timestamp":1775865600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T00:00:00Z","timestamp":1775865600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Muscle and Nerve"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction\/Aims<\/jats:title>\n                    <jats:p>Polyneuropathy (PN) in Parkinson's disease (PD) remains underrecognized in clinical practice despite increasing evidence of its prevalence, especially among patients receiving levodopa therapy. Both iatrogenic and neurodegenerative mechanisms have been proposed. This study aimed to assess the prevalence and characteristics of PN in PD patients across different therapeutic regimens, including a longitudinal evaluation of those initiating levodopa\u2013carbidopa intestinal gel (LCIG).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a prospective observational study on 66 PD patients classified into levodopa\u2010na\u00efve (noLEV), moderate\u2010dose (modLEV), and high\u2010dose (highLEV) groups. Clinical, neurophysiological, and biochemical evaluations were performed at baseline. A subgroup of 17 patients initiating LCIG underwent follow\u2010up assessments after a mean of 40\u2009months. PN diagnosis was based on clinical and nerve conduction study (NCS) criteria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      At baseline, 22.7% of patients had PN. PN prevalence increased significantly with higher levodopa doses (38.4% in highLEV vs. 10% in noLEV,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.047). Patients with PN had higher homocysteine (Hcy) and lower vitamin B12\/folate levels. LEV dosage demonstrated weak positive correlations with Hcy and weak to moderate negative correlations with sensory and motor nerve amplitudes. Among LCIG\u2010treated patients, PN prevalence rose from 17.6% to 47% at follow\u2010up, with a 35.7% incidence of new\u2010onset PN. The change in levodopa dosage was the main predictor of PN development.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This study confirms that PN is a common comorbidity in PD, strongly associated with levodopa exposure, particularly at higher doses or via LCIG. Routine clinical, neurophysiological and biochemical monitoring is essential to identify at\u2010risk patients and guide preventive strategies, including vitamin supplementation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/mus.70243","type":"journal-article","created":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T07:11:36Z","timestamp":1775891496000},"page":"22-29","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Is Levodopa Fueling Peripheral Nerve Damage? A Clinical and Neurophysiological Insight Into Polyneuropathy in Parkinson's Disease"],"prefix":"10.1002","volume":"74","author":[{"given":"Elena","family":"Garasto","sequence":"first","affiliation":[{"name":"Department of Systems Medicine University of Rome \u201cTor Vergata\u201d  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristi","family":"Meksi","sequence":"additional","affiliation":[{"name":"Department of Systems Medicine University of Rome \u201cTor Vergata\u201d  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1446-0588","authenticated-orcid":false,"given":"Rocco","family":"Cerroni","sequence":"additional","affiliation":[{"name":"Parkinson's Disease Center Tor Vergata University Hospital  Rome Italy"},{"name":"Neurology Unit Tor Vergata University Hospital  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola Biagio","family":"Mercuri","sequence":"additional","affiliation":[{"name":"Department of Systems Medicine University of Rome \u201cTor Vergata\u201d  Rome Italy"},{"name":"Parkinson's Disease Center Tor Vergata University Hospital  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Stefani","sequence":"additional","affiliation":[{"name":"Department of Systems Medicine University of Rome \u201cTor Vergata\u201d  Rome Italy"},{"name":"Parkinson's Disease Center Tor Vergata University Hospital  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camilla","family":"Rocchi","sequence":"additional","affiliation":[{"name":"Neurology Unit Tor Vergata University Hospital  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,11]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2014.10.010"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2016.01.026"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.20113"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2013.09.007"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.22137"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e31823a0ee4"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000004274"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2018.10.003"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s42466\u2010024\u201000354\u2010z"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.25585"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.61.5.657"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm8101533"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.3349\/ymj.2020.61.12.1050"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1464-5491.2001.00445.x"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2012.08.002"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0066639"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/mdc3.12688"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.26424"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.20213"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.22340"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.WNL.0000149522.32823.EA"},{"key":"e_1_2_12_23_1","first-page":"251","volume-title":"Handbook of Clinical Neurology","author":"Ferrante M. 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