{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T10:34:50Z","timestamp":1785926090959,"version":"3.56.0"},"reference-count":46,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T00:00:00Z","timestamp":1756425600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100001321","name":"National Research Foundation","doi-asserted-by":"publisher","award":["RS-2023-00208906"],"award-info":[{"award-number":["RS-2023-00208906"]}],"id":[{"id":"10.13039\/501100001321","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001321","name":"National Research Foundation","doi-asserted-by":"publisher","award":["S-2021-NR061646"],"award-info":[{"award-number":["S-2021-NR061646"]}],"id":[{"id":"10.13039\/501100001321","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001321","name":"National Research Foundation","doi-asserted-by":"publisher","award":["2021R1C1C1011822"],"award-info":[{"award-number":["2021R1C1C1011822"]}],"id":[{"id":"10.13039\/501100001321","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,8,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Although recent evidence suggests that glycemic variability (GV) has a negative impact on neurodegeneration, its role in Parkinson\u2019s disease (PD) remains unclear.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To explore the association between long-term GV and longitudinal motor and nonmotor progression in patients with PD and to uncover the disease-specific and nonspecific mechanisms underlying this association.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We used data obtained from the Parkinson\u2019s Progression Markers Initiative cohort. Three hundred seventy-seven patients with early untreated PD underwent annual motor and nonmotor assessments covering neuropsychiatric, sleep-related, and autonomic symptoms for up to 8\u00a0years of follow-up. Dopamine transporter (DAT) imaging results and cerebrospinal fluid (CSF) marker levels, including \u03b1-synuclein, \u03b2-amyloid 1\u201342, total tau, phosphorylated tau181, and neurofilament light chain (NfL) were collected at baseline and for up to 6\u00a0years of follow-up. We defined GV as the intra-individual visit-to-visit variability in annual fasting blood glucose levels.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>With respect to motor symptoms, a greater GV was associated with a greater increase in postural instability\/gait difficulty scores (P\u2009=\u2009.001) and a greater risk of developing freezing of gait (P\u2009=\u2009.002). With respect to nonmotor symptoms, higher GV was associated with a steeper decrease in Montreal Cognitive Assessment (P\u2009&amp;lt;\u2009.001) and semantic fluency test (P\u2009=\u2009.002) scores and a greater increase in Geriatric Depression Scale scores (P\u2009=\u2009.001). With respect to DAT imaging and CSF biomarkers, increased GV was associated with a greater increase in CSF NfL levels (P\u2009=\u2009.001) but not with other biomarker changes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Our findings suggest that increased GV is related to unfavourable motor and nonmotor outcomes in patients with PD. However, we did not identify the specific mechanisms underlying these GV-related effects, despite its association with more severe neurodegeneration.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ageing\/afaf220","type":"journal-article","created":{"date-parts":[[2025,8,31]],"date-time":"2025-08-31T11:06:55Z","timestamp":1756638415000},"source":"Crossref","is-referenced-by-count":3,"title":["Association of long-term glycemic variability with longitudinal motor and nonmotor progression in patients with Parkinson\u2019s disease: an 8-year follow-up"],"prefix":"10.1093","volume":"54","author":[{"given":"Ryul","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Neurology, Seoul Metropolitan Government\u2014Seoul National University Boramae Medical Center, Seoul National University College of Medicine , Seoul ,","place":["South 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