Objective: In this study, we aimed to investigate the potential determinants of QoL in brain-first and body-first patients with PD.
Background: Parkinson’s disease (PD) is a neurodegenerative disease with high heterogeneity, and the proposed body-first and brain-first PD subtypes are classified based on the initial localization of α-synuclein inclusions. However, little is known about the quality of life (QoL) in terms of these PD subtypes.
Method: 1632 PD patients were recruited in this study, including 890 PDpRBD–（putative brain-first） patients and 742 PDpRBD+（putative body-first） patients. All patients underwent QoL assessment with PDQ-39, together with detailed clinical and neuropsychological evaluations. Spearman rank correlation analysis and multiple stepwise regression were performed to investigate potential determinants of QoL.
Results: Compared withPDpRBD–patients , patients of PDpRBD+ exhibited greater QoL impairment. Determinants of QoL are heterogeneous in two subtypes. The Geriatric Depression Rating Scale (GDS) score, Unified Parkinson’s Disease Rating Scale part III (UPDRS-III) score, Non-Motor Symptoms Questionnaire (NMSQ) score, education, Mini Mental State Examination (MMSE) score and Epworth Sleepiness Score (ESS) were independent determinants of QoL inPDpRBD- patients. GDS score, UPDRS-III score, Levodopa equivalent daily dose (LEDD), NMSS score and REM-sleep Behavior Disorder Screening Questionnaire (RBDSQ) score were independent determinants of QoL inPDpRBD+ patients.
Conclusion: Body-first PD was associated with more pronounced QoL impairment. Depression and motor symptoms were identified as common determinants of QoL in both subtypes, while cognition and RBD were unique determinants in brain-first and body-first patients, respectively. These findings highlight the need for subtype-specific management strategies tailored to the underlying determinants to optimize patient outcomes.
To cite this abstract in AMA style:
XN. Liu, YL. Tang, XN. Liang, J. Wang. Determinants of Quality of Life According to Brain-first and Body-first in Patients with Parkinson’s Disease [abstract]. Mov Disord. 2026; 41 (suppl 1). https://www.mdsabstracts.org/abstract/determinants-of-quality-of-life-according-to-brain-first-and-body-first-in-patients-with-parkinsons-disease/. Accessed October 1, 2026.« Back to 2026 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/determinants-of-quality-of-life-according-to-brain-first-and-body-first-in-patients-with-parkinsons-disease/