Fig. 3: Stratification of idiopathic PD based on the ratio of glucosylceramide to sphingomyelin (GlcCer/SM ratio) at enrollment.

Idiopathic PD patients with the highest quartile of GlcCer/SM ratio at enrollment (magenta) had an accelerated longitudinal cognitive decline compared to those with the lowest quartile of GlcCer/SM ratio (cyan). Model-predicted mean Montreal Cognitive Assessment (MoCA) scores (solid lines) and standard errors (shaded areas) across time are shown for idiopathic PD patients in the highest (n = 48) and lowest (n = 47) quartile of GlcCer/SM ratios at enrollment visits. Fixed effects covariates included in the model were time in study (years), GlcCer/SM ratio, the interaction of GlcCer/SM ratio and time in study, age at baseline, the interaction of age at baseline and time in study, and sex. For the purpose of the graph, sex was arbitrarily set to female. Similar results were seen when sex was set to male (not shown).