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Four hundred twenty\u2010three patients with Parkinson's disease (PD; EDS: non\u2010EDS\u2009=\u2009357:66) and 195 healthy controls (HCs; EDS: nEDS\u2009=\u2009171:24) were enrolled in our study at baseline. Multiple linear and linear mixed\u2010effects models were used to research the relationships between EDS\/daytime sleepiness severity and clinical characteristics. Relationships between the change rates of clinical characteristics and daytime sleepiness severity were further investigated through multiple linear regression models. Mediating effect analysis was used to determine whether autonomic dysfunction was the mediator between cognition assessments and daytime sleepiness severity. Patients with PD with EDS and greater daytime sleepiness severity presented faster cognitive decline, high possibility for rapid eye movement sleep behavior disorder, autonomic dysfunction, depression, and anxiety from cross\u2010sectional and longitudinal analyses. Furthermore, HC individuals with EDS showed a higher striatal binding ratio of the right putamen, right striatum, and mean striatum. Autonomic dysfunction may act as a mediator between PD and cognitive decline. In early PD, EDS and daytime sleepiness severity were related to several clinical variables, suggesting that EDS might play an essential role in regulating PD progression.<\/jats:p>","DOI":"10.1111\/cts.13610","type":"journal-article","created":{"date-parts":[[2023,8,8]],"date-time":"2023-08-08T11:17:34Z","timestamp":1691493454000},"page":"2033-2045","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Clinical characteristics in early Parkinson's disease with excessive daytime sleepiness: A cross\u2010sectional and longitudinal study"],"prefix":"10.1111","volume":"16","author":[{"given":"Yumei","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Neurology Affiliated Hospital of Qingdao University  Qingdao China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling","family":"Xue","sequence":"additional","affiliation":[{"name":"Brain Department Affiliated Taian City Central Hospital of Qingdao University  Taian China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Zhao","sequence":"additional","affiliation":[{"name":"Brain Department Affiliated Taian City Central Hospital of Qingdao University  Taian China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaixin","family":"Dou","sequence":"additional","affiliation":[{"name":"Department of Neurology Affiliated Hospital of Qingdao University  Qingdao China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guojun","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Affiliated Taian City Central Hospital of Qingdao University  Taian China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anmu","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Neurology Affiliated Hospital of Qingdao University  Qingdao 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