{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T11:16:41Z","timestamp":1784114201762,"version":"3.55.0"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,4,12]],"date-time":"2023-04-12T00:00:00Z","timestamp":1681257600000},"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. Neurol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Autonomic dysfunction, including gastrointestinal, cardiovascular, and urinary dysfunction, is often present in early Parkinson's Disease (PD). However, the knowledge of the longitudinal progression of these symptoms, and the connection between different autonomic domains, is limited. Furthermore, the relationship between the presence of autonomic symptoms in early-stage PD and olfactory dysfunction, a possible marker of central nervous system involvement, has not been fully investigated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>We aimed to investigate the occurrence and progression of autonomic dysfunction in recently diagnosed (&amp;lt; 2 years) untreated PD patients and determine any coexistence of symptoms in individual patients. We also investigated the relationship between autonomic symptoms, olfactory dysfunction, and motor impairment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data were obtained from the Parkinson's Progression Markers Initiative (PPMI) database. Autonomic dysfunction was measured using the Scales for Outcomes in Parkinson's Disease (SCOPA-AUT). Symptom frequency and mean scores over 7 years were determined. The simultaneous occurrence of different autonomic symptoms was also examined. Finally, the relationships between SCOPA-AUT scores, olfactory dysfunction, and motor impairment were investigated using the University of Pennsylvania Smell Identification Test (UPSIT) and the Movement Disorder Society\u2014Unified Parkinson's Disease Rating Scale (MDS-UPDRS), respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Follow-up data were available for 7 years for 171 PD patients and for 5 years for 136 HCs. Mean SCOPA-AUT score increased significantly from baseline to the 7-year follow-up for each autonomic domain, except for female sexual dysfunction. Most patients reported three or more autonomic symptoms. Common clusters of symptoms were composed of combinations of gastrointestinal, urinary, thermoregulatory, and sexual dysfunction. At baseline, greater SCOPA-AUT total score was associated with lower UPSIT scores (<jats:italic>r<\/jats:italic> = \u22120.209, <jats:italic>p<\/jats:italic> = 0.006) and with greater total MDS-UDPRS III score (<jats:italic>r<\/jats:italic> = 0.218, <jats:italic>p<\/jats:italic> = 0.004).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Autonomic dysfunction, often with coexistence of autonomic manifestations, is common in early PD and progressively worsens over the first 7 years of disease, suggesting that these symptoms should be addressed with appropriate treatments early in the disease. The association between greater autonomic dysfunction and greater olfactory impairment, coupled with the association with more severe motor scores at baseline, indicates that patients who show more severe autonomic dysfunction could also have more severe involvement of the central nervous system at the time of diagnosis.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2023.1155669","type":"journal-article","created":{"date-parts":[[2023,4,12]],"date-time":"2023-04-12T05:12:10Z","timestamp":1681276330000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":20,"title":["The longitudinal progression of autonomic dysfunction in Parkinson's disease: A 7-year study"],"prefix":"10.3389","volume":"14","author":[{"given":"Charlotte B.","family":"Stewart","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Ledingham","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria K.","family":"Foster","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirstie N.","family":"Anderson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sahana","family":"Sathyanarayana","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debra","family":"Galley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Pavese","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacopo","family":"Pasquini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,4,12]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"207","DOI":"10.1007\/s13760-016-0739-6","article-title":"Impact of autonomic dysfunctions on the quality of life in Parkinson's disease patients","volume":"117","author":"Tomic","year":"2017","journal-title":"Acta Neurol Belg."},{"key":"B2","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1016\/j.parkreldis.2019.07.008","article-title":"Longitudinal assessment of autonomic dysfunction in early Parkinson's disease","volume":"66","author":"Stankovi\u0107","year":"2019","journal-title":"Parkinsonism Relat Disord."},{"key":"B3","doi-asserted-by":"publisher","first-page":"970","DOI":"10.1001\/jamaneurol.2017.1125","article-title":"Association of autonomic dysfunction with disease progression and survival in Parkinson's disease","volume":"74","author":"De Pablo-Fernandez","year":"2017","journal-title":"JAMA Neurol."},{"key":"B4","doi-asserted-by":"publisher","first-page":"597","DOI":"10.1002\/mds.25445","article-title":"Prodromal autonomic symptoms and signs in Parkinson's disease and dementia with Lewy bodies","volume":"28","author":"Postuma","year":"2013","journal-title":"Movement Disorders."},{"key":"B5","doi-asserted-by":"publisher","first-page":"161","DOI":"10.1001\/jamaneurol.2022.3902","article-title":"Widening the spectrum of risk factors, comorbidities, and prodromal features of Parkinson disease","volume":"80","author":"Schrag","year":"2023","journal-title":"JAMA Neurol."},{"key":"B6","doi-asserted-by":"publisher","first-page":"2012","DOI":"10.1212\/01.wnl.0000264429.59379.d9","article-title":"Do \u03b1-synuclein aggregates in autonomic plexuses predate Lewy body disorders? 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