it is a prospective longitudinal observational study, aiming to to identify clinical, and biochemical baseline predictors of motor and non-motor PD progression in sample of Egyptian patients. it measures the baseline motor, non-motor, biochemical and imaging characteristics at enrollment and its relation to PD progression over 3 years.~The aim of this study is to identify clinical, and biochemical baseline predictors of motor and non-motor PD progression in sample of Egyptian patients.~Methods:~Assessment:-~Time • During the 2 years recruitment of patients from 2019 to 2021, the assessment will be at base line (first clinic visit), after 1yr, and after 2yrs.~Patients will be subjected to:~Clinical assessment:~At base line, Patients will complete an extensive clinical evaluation, including:~Comprehensive medical history and neurological examination.~Demographic information (sex, age, education level, and occupation), as well as clinical characteristics of them (age at onset, duration of illness, received medications and doses).~Motor assessment; Movement Disorder Society (MDS) -Unified Parkinson's Disease Rating Scale (MDS-UPDRS) he motor portion (Part III) during OFF and ON states, Hoehn & Yahr, and Schwab & England scales.~Gait assessment, Gait will be assessed by:~Freezing of gait questionnaire Berg balance scale 10 m walk test Timed up and go test~Physical activity scale for elderly (PASE). Cognitive assessment; MOCA, MMSE. Cognitive assessment : during On state.~All patients will be evaluated for global cognitive assessment by:~Mini Mental State Examination (MMSE)Arabic version~Montreal Cognitive Assessment (MoCA) Arabic version~The standard battery included cognitive tests in the following domains: visuospatial skills, language, attention, executive functioning, and memory.~Visuospatial skills will be assessed by clock drawing test and copy the intersecting pentagons of Addenbrooke's test (Arabic version)~Language will be examined by Language similarity & language subset of Addenbrooke's test (Arabic version)~Attention will be evaluated by forward &backward digit span tests and by the number of seconds needed to sequence numbers using a pencil (Trail making test A)~For the evaluation of memory, participants will complete Wechsler memory subset, and investigators also will use their three-item recall from the MMSE.~Executive functions will be measured by Wisconsin card sorting test and also Semantic verbal fluency test .~The non-motor symptoms scales (NMSS). Beck depression inventory (BDI). The Arabic version of The Parkinson's Disease Questionnaire (PDQ-39). Lab investigations MRI brain or CT brain . Serum alpha -Synuclein auto antibodies~All the following will be done at baseline, after 1 year, and after 2 year except, MRI brain and serum alpha-synuclein (only at baseline ).~This study will be approved from the ethical committee of Faculty of Medicine, Ain -Shams University.
it is a prospective longitudinal observational study, aiming to to identify clinical, and biochemical baseline predictors of motor and non-motor PD progression in sample of Egyptian patients. it measures the baseline motor, non-motor, biochemical and imaging characteristics at enrollment and its relation to PD progression over 3 years