{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T06:23:46Z","timestamp":1787639026919,"version":"build-2736575974"},"reference-count":94,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T00:00:00Z","timestamp":1787616000000},"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>Parkinson\u2019s disease (PD) is associated with diverse non-motor symptoms (NMS), including depression, anxiety, anhedonia, bipolar-spectrum features, and impulsive-compulsive behaviors (ICBs), which substantially impair quality of life. Although these domains may share dopaminergic and frontostriatal mechanisms, they are often studied separately. This study adopted a transdiagnostic, person-centered approach to identify clinically meaningful NMS profiles in PD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this cross-sectional study, 126 patients with PD and no dementia diagnosis from two university centers completed validated assessments of ICBs, impulsivity, anhedonia, depression, anxiety, and bipolar-spectrum symptoms. K-means clustering was applied to standardized variables, and cluster validity was evaluated using multiple stability metrics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The four-cluster solution demonstrated the best validity and identified Low-Symptom (44.3%), Moderate Internalizing (29.4%), Bipolar\u2013Impulsive (16.7%), and Severe Internalizing\u2013Impulsive (9.5%) profiles. Clusters differed significantly across depression, anxiety, anhedonia, bipolar-spectrum symptoms, ICBs, and impulsivity. The Bipolar\u2013Impulsive group was significantly younger, whereas the Moderate Internalizing profile was older and predominantly female. The Severe Internalizing\u2013Impulsive cluster showed the highest psychiatric burden, motor severity, disease stage, dopaminergic treatment load, and amantadine use. No significant between-cluster differences emerged in global cognitive performance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>These findings support a transdiagnostic model in PD in which affective dysregulation and impulsivity interact with disease-related factors to form distinct neuropsychiatric phenotypes. Recognizing these profiles may facilitate earlier identification of vulnerable patients and more individualized neuropsychiatric management strategies beyond a solely dopaminergic framework.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnagi.2026.1898498","type":"journal-article","created":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T05:34:50Z","timestamp":1787636090000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["A transdiagnostic approach to non-motor symptoms in Parkinson\u2019s disease: exploring internalizing, bipolar spectrum, and impulsive compulsive behavior profiles via cluster analysis"],"prefix":"10.3389","volume":"18","author":[{"given":"Ard\u0131l Bayram","family":"\u015eahin","sequence":"first","affiliation":[{"name":"Graduate School of Health Sciences, Ko\u00e7 University","place":["Istanbul, T\u00fcrkiye"]},{"name":"Research Center for Translational Medicine (KUTTAM), Ko\u00e7 University","place":["Istanbul, T\u00fcrkiye"]},{"name":"Department of Psychiatry, Faculty of Medicine, Biruni University","place":["Istanbul, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahmoud","family":"Mahmoudi","sequence":"additional","affiliation":[{"name":"Graduate School of Health Sciences, Ko\u00e7 University","place":["Istanbul, T\u00fcrkiye"]},{"name":"Research Center for Translational Medicine (KUTTAM), Ko\u00e7 University","place":["Istanbul, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasemin","family":"Kadand\u0131r","sequence":"additional","affiliation":[{"name":"School of Medicine, Ko\u00e7 University","place":["Istanbul, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u0130brahim Melih","family":"\u00d6zt\u00fcrkmen","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Hacettepe University","place":["Ankara, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elif Sude","family":"\u00d6za\u015fik","sequence":"additional","affiliation":[{"name":"Department of Psychology, Atlas University","place":["Istanbul, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roza","family":"G\u00f6k","sequence":"additional","affiliation":[{"name":"School of Medicine, Ko\u00e7 University","place":["Istanbul, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammet Nesip","family":"Seyido\u011flu","sequence":"additional","affiliation":[{"name":"School of Medicine, Ko\u00e7 University","place":["Istanbul, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c7\u0131nar","family":"\u00d6ztosun","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, School of Medicine, Rush University","place":["Chicago, IL, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00d6zg\u00fcr","family":"\u00d6ztop \u00c7akmak","sequence":"additional","affiliation":[{"name":"Department of Neurology, School of Medicine, Ko\u00e7 University","place":["Istanbul, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G\u00fcl","family":"Yal\u00e7\u0131n \u00c7akmakl\u0131","sequence":"additional","affiliation":[{"name":"Department of Neurology, Faculty of Medicine","place":["Hacettepe University Ankara, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fahriye Feriha","family":"\u00d6zer","sequence":"additional","affiliation":[{"name":"Department of Neurology, Ko\u00e7 University Hospital","place":["Istanbul, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hale","family":"Yapici Eser","sequence":"additional","affiliation":[{"name":"Graduate School of Health Sciences, Ko\u00e7 University","place":["Istanbul, T\u00fcrkiye"]},{"name":"Research Center for Translational Medicine (KUTTAM), Ko\u00e7 University","place":["Istanbul, T\u00fcrkiye"]},{"name":"Department of Psychiatry-Neuroscience, School of Medicine, Ko\u00e7 University","place":["Istanbul, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,25]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1002\/mdc3.12556","article-title":"Turkish standardization of movement disorders society unified Parkinson\u2019s disease rating scale and unified dyskinesia rating scale","volume":"5","author":"Akbostanci","year":"2018","journal-title":"Mov. 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