{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T08:22:14Z","timestamp":1793607734322,"version":"4.5.0"},"reference-count":42,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,1,24]],"date-time":"2025-01-24T00:00:00Z","timestamp":1737676800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Aging Neurosci."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Non-alcoholic fatty liver disease (NAFLD) or liver fibrosis may share similar pathophysiological features with Parkinson\u2019s disease (PD), yet their correlation was unclear. This study aimed to explore their correlation between PD and liver fibrosis using the fibrosis-4 score (FIB-4) as a surrogate marker.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed Parkinson\u2019s Progression Markers Initiative (PPMI) data and enrolled PD patients with comprehensive baseline and 5-year follow-up time-point clinical data. Participants were categorized based on FIB-4 levels to assess the association between FIB-4 scores and various clinical scales, controlling for potential confounders. Differences in the progression of clinical scales over five years were compared using generalized linear mixed models (GLMM).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Baseline FIB-4 levels positively correlated to scores of baseline section III of the Unified-Parkinson Disease Rating Scale (UPDRS III) (\n                      <jats:italic>r<\/jats:italic>\n                      \u202f=\u202f0.145,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.017), Epworth Sleepiness Scale (EPSS) (\n                      <jats:italic>r<\/jats:italic>\n                      \u202f=\u202f0.140,\n                      <jats:italic>P<\/jats:italic>\n                      \u202f=\u202f0.022), Hopkins Verbal Learning Test (HVLT)-delayed recall (\n                      <jats:italic>r<\/jats:italic>\n                      \u202f=\u202f0.128,\n                      <jats:italic>P<\/jats:italic>\n                      \u202f=\u202f0.036) and HVLT-retention (\n                      <jats:italic>r<\/jats:italic>\n                      \u202f=\u202f0.128,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.036). GLMM analysis revealed an independent correlation between FIB-4 subgroup*time and several clinical scales including the State-trait Anxiety Inventory (STAI), Symbol Digit Modalities Test (SDMT), Semantic Fluency Test (SF), HVLT-total recall, and HVLT-delayed recall, with the high FIB-4 subgroup exhibiting a greater decline in these scores compared to the low FIB-4 subgroup (all\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt;0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Elevated baseline FIB-4 correlated to more severe baseline daytime sleepiness, motor symptoms, and memory function in PD patients, along with a more rapid decline in cognitive functions such as executive function, information processing ability, and memory. Additionally, a high FIB-4 might confer a protective effect against anxiety.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnagi.2025.1501319","type":"journal-article","created":{"date-parts":[[2025,1,24]],"date-time":"2025-01-24T02:14:59Z","timestamp":1737684899000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Baseline liver fibrosis-4 score correlates to the progression of anxiety and cognitive impairment in patients with Parkinson\u2019s disease"],"prefix":"10.3389","volume":"17","author":[{"given":"Yongqing","family":"Cheng","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Honghong","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingchao","family":"Ge","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Guo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuangfei","family":"You","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guojun","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shouru","family":"Xue","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,1,24]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1198871","DOI":"10.3389\/fonc.2023.1198871","article-title":"Fibrosis-4 index is associated with the risk of hepatocellular carcinoma in patients with cirrhosis and nonalcoholic steatohepatitis","volume":"13","author":"Albhaisi","year":"2023","journal-title":"Front. 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Dis."},{"key":"ref5","doi-asserted-by":"publisher","first-page":"375","DOI":"10.3389\/fneur.2019.00375","article-title":"The paradoxical protective effect of liver steatosis on severity and functional outcome of ischemic stroke","volume":"10","author":"Baik","year":"2019","journal-title":"Front. Neurol."},{"key":"ref6","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1002\/cld.722","article-title":"The diagnosis and management of nonalcoholic fatty liver disease: practice guidance from the American association for the study of liver diseases","volume":"11","author":"Chalasani","year":"2018","journal-title":"Clin. Liver Dis."},{"key":"ref7","doi-asserted-by":"publisher","first-page":"4392","DOI":"10.1007\/s00415-024-12374-5","article-title":"GBA moderates cognitive reserve\u2019s effect on cognitive function in patients with Parkinson\u2019s disease","volume":"271","author":"Chang","year":"2024","journal-title":"J Neurol"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"229","DOI":"10.3390\/biomedicines8070229","article-title":"Depression and cognitive impairment\u2014extrahepatic manifestations of NAFLD and NASH","volume":"8","author":"Colognesi","year":"2020","journal-title":"Biomedicines"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2022.10.035","article-title":"Longitudinal changes in fibrosis markers are associated with risk of cirrhosis and hepatocellular carcinoma in non-alcoholic fatty liver disease","volume":"78","author":"George","year":"2022","journal-title":"J. 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Disord."},{"key":"ref34","doi-asserted-by":"publisher","first-page":"864263","DOI":"10.3389\/fphys.2022.864263","article-title":"Metabolic diffusion in neuropathologies: the relevance of brain-liver axis","volume":"13","author":"Vegas-Su\u00e1rez","year":"2022","journal-title":"Front. Physiol."},{"key":"ref35","doi-asserted-by":"publisher","first-page":"453","DOI":"10.14309\/ajg.0000000000001606","article-title":"Fibrosis-4 index can independently predict major adverse cardiovascular events in nonalcoholic fatty liver disease","volume":"117","author":"Vieira Barbosa","year":"2022","journal-title":"Am J Gastroenterol."},{"key":"ref36","doi-asserted-by":"publisher","first-page":"812030","DOI":"10.3389\/fcvm.2022.812030","article-title":"Association between non-alcoholic fatty liver disease and risk of stroke: a systematic review and meta-analysis","volume":"9","author":"Wang","year":"2022","journal-title":"Front. Cardiovasc. 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Parkinson's Dis."},{"key":"ref42","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1016\/j.jocn.2023.11.019","article-title":"Association of liver fibrosis with cognitive decline in Parkinson\u2019s disease","volume":"119","author":"Zolin","year":"2024","journal-title":"J. Clin. 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