van Wamelen, Daniel JSauerbier, AnnaLeta, ValentinaRodriguez-Blazquez, CarmenFalup-Pecurariu, CristianRodríguez-Violante, MayelaRizos, AlexandraTsuboi, YMetta, VinodBhidayasiri, RoongrojBhattacharya, KalyanBorgohain, RupamPrashanth, L KRosales, RaymondLewis, SimonFung, VictorBehari, MadhuriGoyal, VinayKishore, AshaLloret, Santiago PerezMartínez-Martín, PabloChaudhuri, Kallol Ray2022-07-202022-07-202021-05-05Sci Rep. 2021 May 5;11(1):9611.http://hdl.handle.net/20.500.12105/14733Growing evidence suggests that non-motor symptoms (NMS) in Parkinson's disease (PD) have differential progression patterns that have a different natural history from motor progression and may be geographically influenced. We conducted a cross-sectional analysis of 1607 PD patients of whom 1327 were from Europe, 208 from the Americas, and 72 from Asia. The primary objective was to assess baseline non-motor burden, defined by Non-Motor Symptoms Scale (NMSS) total scores. Other aims included identifying the factors predicting quality of life, differences in non-motor burden between drug-naïve and non-drug-naïve treated patients, and non-motor phenotypes across different geographical locations. Mean age was 65.9 ± 10.8 years, mean disease duration 6.3 ± 5.6 years, median Hoehn and Yahr stage was 2 (2-3), and 64.2% were male. In this cohort, mean NMSS scores were 46.7 ± 37.2. Differences in non-motor burden and patterns differed significantly between drug-naïve participants, those with a disease duration of less than five years, and those with a duration of five years or over (p ≤ 0.018). Significant differences were observed in geographical distribution (NMSS Europe: 46.4 ± 36.3; Americas: 55.3 ± 42.8; Asia: 26.6 ± 25.1; p < 0.001), with differences in sleep/fatigue, urinary, sexual, and miscellaneous domains (p ≤ 0.020). The best predictor of quality of life was the mood/apathy domain (β = 0.308, p < 0.001). This global study reveals that while non-motor symptoms are globally present with severe NMS burden impacting quality of life in PD, there appear to be differences depending on disease duration and geographical distribution.engVoRhttp://creativecommons.org/licenses/by/4.0/Quality of LifeAgedApathyCross-Sectional StudiesFatigueFemaleHumansLongitudinal StudiesMaleMiddle AgedParkinson DiseaseSeverity of Illness IndexSleepAtribución 4.0 Internacional33953218111961110.1038/s41598-021-88651-42045-2322Scientific Reportsopen access