Objective: To identify the non-motor symptom (NMS) subtype associated with diagnostic latency (DL) in people living with Parkinson Disease (PwP).

Background: The NMS subtypes have been classified based on their clinical characteristics [1]. NMS vary according to disease progression, as certain NMS are pre-motor [2]. Although, no studies have yet assessed the relationship between these subtypes and DL in PwP.

Method: An observational cross-sectional study was carried out at a referral center. PwP  were assessed using the MDS-UPDRS 3, MDS-NMS, and HY. Sociodemographic, clinical and onset data were collected. Clustering was performed using Gaussian mixture model [3], identifying 3 NMS subtypes according to symptom severity [figure 1]. A linear regression analysis was performed, with years of diagnostic latency as the outcome variable.

Results: 124 PwP (50.8 % women, age 63.2 ±11.1, DL 1.10 ±1.49) were included. In the comparative analysis, gender (severe NMS subtype with more female than male patients, with p=0.049 in post-hoc analysis) and family history of PD (moderate NMS subtype with p=0.004 in post-hoc analysis)  were statistically significant (p=0.049 and p=0.004, respectively) [table 1]. In the linear regression model, no NMS subtype was identified as determinant for DL [table 2].

Conclusion: After controlling for confounding variables, the NMS subtype was not found to be a determining factor for DL. As previously reported, gender plays a significant role in DL. A key limitation of this study was the small sample size, highlighting the need for further research with larger PwP cohorts to refine NMS subtypes, particularly those exclusively non-motor.

Figure 1.

Comparative Analysis Between NMS Subtypes

Table 2 . Lineal Regression Model

References: 1.Chaudhuri KR, Poplawska-Domaszewicz K, Subramanian I, Jost WH. Non motor Parkinson: subtypes, biomarkers, stepped care and a journal! Journal of Neural Transmission [Internet]. 2025 Feb 15; Available from: https://link.springer.com/10.1007/s00702-025-02895-2
2.Qamar MA, Tall P, van Wamelen D, Wan YM, Rukavina K, Fieldwalker A, et al. Setting the clinical context to non-motor symptoms reflected by Park-pain, Park-sleep, and Park-autonomic subtypes of Parkinson’s disease. In: International Review of Neurobiology. Academic Press Inc.; 2024. p. 1–58.
3.Rodriguez-Sanchez F, Rodriguez-Blazquez C, Bielza C, Larrañaga P, Weintraub D, Martinez-Martin P, et al. Identifying Parkinson’s disease subtypes with motor and non-motor symptoms via model-based multi-partition clustering. Scientific Reports. 2021 Dec 1;11(1).

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MDS Abstracts - https://www.mdsabstracts.org/abstract/evaluation-of-diagnostic-latency-in-parkinsons-disease-based-on-non-motor-symptoms-subtype/