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ORIGINAL RESEARCH article

Front. Aging Neurosci.
Sec. Parkinson’s Disease and Aging-related Movement Disorders
Volume 17 - 2025 | doi: 10.3389/fnagi.2025.1501319
This article is part of the Research Topic A comprehensive look at biomarkers in neurodegenerative diseases: from early diagnosis to treatment response assessment View all 21 articles

Baseline liver fibrosis-4 score correlates to the progression of anxiety and cognitive impairment in patients with Parkinson's disease

Provisionally accepted
Yongqing Cheng Yongqing Cheng 1Li Chen Li Chen 2*Honghong Zhu Honghong Zhu 1*颖超 Ge 颖超 Ge 3Lei Li Lei Li 1*Yan Guo Yan Guo 1Xin Wang Xin Wang 1*Shuangfei You Shuangfei You 1*Guojun He Guojun He 1*Shouru Xue Shouru Xue 4*
  • 1 Yancheng First People's Hospital, Yancheng, China
  • 2 Jiangsu Funing People’s Hospital, Funing, Jiangsu Province, China
  • 3 Qidong People's Hospital, Qidong, Jiangsu Province, China
  • 4 The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China

The final, formatted version of the article will be published soon.

    Background: Non-alcoholic fatty liver disease (NAFLD) or liver fibrosis may share similar pathophysiological features with Parkinson’s disease (PD), yet their correlation was unclear. This study aimed to explore their correlation between PD and liver fibrosis using the fibrosis-4 score (FIB-4) as a surrogate marker. Methods: We analyzed Parkinson’s Progression Markers Initiative (PPMI) data and enrolled PD patients with comprehensive baseline and 5-year follow-up time-point clinical data. Participants were categorized based on FIB-4 levels to assess the association between FIB-4 scores and various clinical scales, controlling for potential confounders. Differences in the progression of clinical scales over five years were compared using generalized linear mixed models (GLMM). Results: Baseline FIB-4 levels positively correlated to scores of baseline section III of the Unified-Parkinson Disease Rating Scale (UPDRS III) (r=0.145, p=0.017), Epworth Sleepiness Scale (EPSS) (r=0.140, P=0.022), Hopkins Verbal Learning Test (HVLT)-delayed recall (r=0.128, P=0.036) and HVLT-retention (r=0.128, P=0.036). GLMM analysis revealed an independent correlation between FIB-4 subgroup*time and several clinical scales including the State-trait Anxiety Inventory (STAI), Symbol Digit Modalities Test (SDMT), Semantic Fluency Test (SF), HVLT-total recall, and HVLT-delayed recall, with the high FIB-4 subgroup exhibiting a greater decline in these scores compared to the low FIB-4 subgroup (all p<0.05). Conclusion: Elevated baseline FIB-4 correlated to more severe baseline daytime sleepiness, motor symptoms, and memory function in PD patients, along with a more rapid decline in cognitive functions such as executive function, information processing ability, and memory. Additionally, a high FIB-4 might confer a protective effect against anxiety.

    Keywords: liver fibrosis-4 score, Parkinson's disease, progression, Cognitive Function, Anxiety

    Received: 24 Sep 2024; Accepted: 10 Jan 2025.

    Copyright: © 2025 Cheng, Chen, Zhu, Ge, Li, Guo, Wang, You, He and Xue. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Li Chen, Jiangsu Funing People’s Hospital, Funing, 224400, Jiangsu Province, China
    Honghong Zhu, Yancheng First People's Hospital, Yancheng, China
    Lei Li, Yancheng First People's Hospital, Yancheng, China
    Xin Wang, Yancheng First People's Hospital, Yancheng, China
    Shuangfei You, Yancheng First People's Hospital, Yancheng, China
    Guojun He, Yancheng First People's Hospital, Yancheng, China
    Shouru Xue, The First Affiliated Hospital of Soochow University, Suzhou, 215006, Jiangsu Province, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.