{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T13:57:39Z","timestamp":1771855059359,"version":"3.50.1"},"reference-count":53,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T00:00:00Z","timestamp":1760313600000},"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>In Parkinson\u2019s disease (PD) patients, the severity of motor symptoms is closely related to the degree of gait disorder and cognitive impairment; notably, the latter also exhibits a significant correlation with gait disorder. Evidently, there exists a complex relationship between motor symptoms, cognitive function, and gait characteristics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study aims to conduct an in-depth analysis of the relationships among MDS-UPDRS III score, MoCA score, and gait parameters by constructing a mediation model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We found that a higher MDS-UPDRS III score was associated with a smaller plantar dorsiflexion angle, slower velocity, and worse swing phase symmetry, and these associations were not mediated by the MoCA score. Age was a confounder in the relationship between MDS-UPDRS III score, MoCA, and velocity. A higher MDS-UPDRS III score was associated with shorter stride length, and this association was partially mediated by the MoCA score.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The results indicated that, when analyzing plantar dorsiflexion angle and swing phase symmetry in PD patients, the influence of motor symptoms was dominant; when analyzing stride length, motor symptoms and cognitive function need to be considered simultaneously; when analyzing velocity, the influence of motor symptoms and age should be focused on.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2025.1659581","type":"journal-article","created":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T04:17:18Z","timestamp":1760329038000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Mediation analysis for integrating motor symptoms of Parkinson\u2019s disease, cognitive function, and gait characteristics"],"prefix":"10.3389","volume":"16","author":[{"given":"Wenchao","family":"Yin","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hong","family":"Gao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruichen","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chenxin","family":"Shen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yue","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cui","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,10,13]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1962123","DOI":"10.1155\/2019\/1962123","article-title":"Gait in Parkinson's disease","volume":"2019","author":"Martinez-Ramirez","year":"2019","journal-title":"Parkinson's Disease"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"697","DOI":"10.1016\/S1474-4422(19)30044-4","article-title":"Gait impairments in Parkinson\u2019s disease","volume":"18","author":"Mirelman","year":"2019","journal-title":"Lancet Neurol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1016\/j.jns.2014.07.026","article-title":"Automated gait and balance parameters diagnose and correlate with severity in Parkinson disease","volume":"345","author":"Dewey","year":"2014","journal-title":"J Neurol Sci"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"308","DOI":"10.1136\/jnnp.69.3.308","article-title":"What contributes to quality of life in patients with Parkinson's disease?","volume":"69","author":"Schrag","year":"2000","journal-title":"J Neurol Neurosur Ps"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1016\/j.parkreldis.2022.06.012","article-title":"Quantitative assessment of gait characteristics in patients with Parkinson\u2019s disease using 2D video","volume":"101","author":"Liu","year":"2022","journal-title":"Parkinsonism Relat Disord"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"752","DOI":"10.1038\/s41598-020-80768-2","article-title":"Gait parameters of Parkinson's disease compared with healthy controls a systematic review and meta-analysis","volume":"11","author":"Zanardi","year":"2021","journal-title":"Sci Rep"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1016\/j.gaitpost.2019.11.005","article-title":"Decreased foot height may be a subclinical shuffling gait in early stage of Parkinson\u2019s disease: a study of three-dimensional motion analysis","volume":"76","author":"Shin","year":"2020","journal-title":"Gait Posture"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"712","DOI":"10.1179\/1743132815Y.0000000043","article-title":"Gait in drug naive patients with de novo Parkinson's disease - 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