{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T16:50:56Z","timestamp":1786121456089,"version":"build-2736575974"},"reference-count":43,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T00:00:00Z","timestamp":1786060800000},"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>Objective<\/jats:title>\n                    <jats:p>Integrated biomarkers for cross-sectional multidimensional assessment of Parkinson\u2019s disease (PD) remain limited. This study examined associations between serum DAPK1, a systemic molecular marker, and peripheral gastric myoelectrical activity assessed by electrogastrography (EGG) in PD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In this cross-sectional study enrolling 203 participants, including 101 healthy controls (HC), 50 early-stage PD (EPD), and 52 mid-to-late-stage PD (LPD), we collected clinical data, serum DAPK1 levels, and EGG measurements. Stage-specific multivariable association frameworks incorporated age, gender, and BMI as key confounders. Statistical evaluation used likelihood ratio tests (LRT), Nagelkerke\u2019s pseudo-R\n                      <jats:sup>2<\/jats:sup>\n                      , integrated discrimination improvement (IDI), and decision-curve analysis (DCA), with internal validation and optimism assessment using 1,000 refit bootstrap resamples.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      For cross-sectional HC-versus-EPD assessment, multivariable analysis identified affective burden, higher DAPK1, and lower postprandial reaction area (PostRA) as independent correlates. The integrated E3 framework improved over the clinical-neuropsychological baseline (IDI = 0.072,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.002), explaining 46.0% of variance (pseudo-R\n                      <jats:sup>2<\/jats:sup>\n                      = 0.460) and achieving an apparent AUC of 0.851. For cross-sectional EPD-versus-LPD assessment, increased DAPK1, decreased preprandial mean amplitude (PreMA), and increased postprandial gastric rhythm (PostGR) were associated with more advanced disease status. The integrated S2 framework showed additional explanatory value (IDI = 0.219,\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.001), explaining 45.8% of variance (pseudo-R\n                      <jats:sup>2<\/jats:sup>\n                      = 0.458) with an apparent AUC of 0.847. DCA suggested potential net benefit for the integrated frameworks within this cohort.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Serum DAPK1 and peripheral EGG measures showed stage-specific cross-sectional associations in PD. Combining systemic DAPK1 and peripheral EGG data may support non-invasive multidimensional assessment of PD, but external validation and longitudinal studies are required before clinical implementation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnagi.2026.1866257","type":"journal-article","created":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T05:29:12Z","timestamp":1786080552000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Multimodal integration of serum DAPK1 and gastric myoelectrical activity reveals stage-specific correlates in Parkinson\u2019s disease"],"prefix":"10.3389","volume":"18","author":[{"given":"Zhining","family":"Li","sequence":"first","affiliation":[{"name":"Department of Neurology, The Second Affiliated Hospital of Xuzhou Medical University, Xuzhou","place":["Jiangsu, China"]},{"name":"Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou","place":["Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pei","family":"Lu","sequence":"additional","affiliation":[{"name":"School of Public Health, Xuzhou Medical University, Xuzhou","place":["Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Can","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neurology, The Second Affiliated Hospital of Xuzhou Medical University, Xuzhou","place":["Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liangqun","family":"Rong","sequence":"additional","affiliation":[{"name":"Department of Neurology, The Second Affiliated Hospital of Xuzhou Medical University, Xuzhou","place":["Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zixuan","family":"Wu","sequence":"additional","affiliation":[{"name":"School of Public Health, Xuzhou Medical University, Xuzhou","place":["Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yumeng","family":"Liu","sequence":"additional","affiliation":[{"name":"School of Public Health, Xuzhou Medical University, Xuzhou","place":["Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuyao","family":"Tian","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, The Chinese University of Hong Kong","place":["Shatin, Hong Kong SAR, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aiping","family":"Gong","sequence":"additional","affiliation":[{"name":"Department of Neurology, The Second Affiliated Hospital of Xuzhou Medical University, Xuzhou","place":["Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lishun","family":"Xiao","sequence":"additional","affiliation":[{"name":"School of Public Health, Xuzhou Medical University, Xuzhou","place":["Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun-feng","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou","place":["Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,7]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"147","DOI":"10.1016\/j.tem.2021.11.005","article-title":"Digesting recent findings: Gut alpha-synuclein, microbiome changes in Parkinson\u2019s disease.","volume":"33","author":"Anis","year":"2022","journal-title":"Trends Endocrinol. 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