{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T15:32:54Z","timestamp":1788449574973,"version":"build-2803163510"},"reference-count":43,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,2,14]],"date-time":"2023-02-14T00:00:00Z","timestamp":1676332800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002347","name":"Bundesministerium f\u00fcr Bildung und Forschung","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002347","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Parkinson's disease (PD) is a multisystem neurodegenerative disorder characterized by motor and non-motor symptoms. In particular, non-motor symptoms have become increasingly relevant to disease progression. This study aimed to reveal which non-motor symptoms have the highest impact on the complex interacting system of various non-motor symptoms and to determine the progression of these interactions over time.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed exploratory network analyses of 499 patients with PD from the Cohort of Patients with Parkinson's Disease in Spain study, who had Non-Motor Symptoms Scale in Parkinson's Disease ratings obtained at baseline and a 2-year follow-up. Patients were aged between 30 and 75 years and had no dementia. The strength centrality measures were determined using the extended Bayesian information criterion and the least absolute shrinkage and selection operator. A network comparison test was conducted for the longitudinal analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Our study revealed that the depressive symptoms <jats:italic>anhedonia<\/jats:italic> and <jats:italic>feeling sad<\/jats:italic> had the strongest impact on the overall pattern of non-motor symptoms in PD. Although several non-motor symptoms increase in intensity over time, their complex interacting networks remain stable.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our results suggest that anhedonia and feeling sad are influential non-motor symptoms in the network and, thus, are promising targets for interventions as they are closely linked to other non-motor symptoms.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2023.972210","type":"journal-article","created":{"date-parts":[[2023,2,14]],"date-time":"2023-02-14T16:31:52Z","timestamp":1676392312000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":9,"title":["Longitudinal analysis of the Non-Motor Symptoms Scale in Parkinson's Disease (NMSS): An exploratory network analysis approach"],"prefix":"10.3389","volume":"14","author":[{"given":"Konstantin G.","family":"Heimrich","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aline","family":"Sch\u00f6nenberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah M.","family":"M\u00fchlhammer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Mendorf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego","family":"Santos-Garc\u00eda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tino","family":"Prell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,2,14]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1016\/bs.irn.2017.02.016","article-title":"The nonmotor features of Parkinson's disease","volume":"132","author":"Titova","year":"2017","journal-title":"Int Rev Neurobiol."},{"key":"B2","doi-asserted-by":"publisher","first-page":"235","DOI":"10.1016\/S1474-4422(06)70373-8","article-title":"Non-motor symptoms of parkinson's disease: diagnosis and management","volume":"5","author":"Chaudhuri","year":"2006","journal-title":"Lancet Neurol."},{"key":"B3","doi-asserted-by":"publisher","first-page":"1641","DOI":"10.1002\/mds.22643","article-title":"The priamo study: a multicenter assessment of nonmotor symptoms and their impact on quality of life in Parkinson's Disease","volume":"24","author":"Barone","year":"2009","journal-title":"Mov Disord."},{"key":"B4","doi-asserted-by":"publisher","first-page":"399","DOI":"10.1002\/mds.23462","article-title":"The impact of non-motor symptoms on health-related quality of life of patients with Parkinson's Disease","volume":"26","author":"Martinez-Martin","year":"2011","journal-title":"Mov Disord."},{"key":"B5","doi-asserted-by":"publisher","first-page":"1901","DOI":"10.1002\/mds.21596","article-title":"The metric properties of a novel non-motor symptoms scale for parkinson's disease: results from an international pilot study","volume":"22","author":"Chaudhuri","year":"2007","journal-title":"Mov Disord."},{"key":"B6","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1111\/ane.13336","article-title":"The non-motor symptoms scale in Parkinson's disease: validation and use","volume":"143","author":"van Wamelen","year":"2021","journal-title":"Acta Neurol Scand."},{"key":"B7","doi-asserted-by":"publisher","first-page":"626","DOI":"10.3390\/jpm11070626","article-title":"Predictors of global non-motor symptoms burden progression in Parkinson's Disease. 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