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We performed a cross-sectional study of 82 Chinese patients with Parkinsons disease(PD)enrolled during an 18-month period using a clinical interview to assess the prevalence of nonmotor symptoms(NMS),the association with disease severity and motor status,and the impact on patients health-related quality of life(Hr-QoL).The patients NMS,Hr-QoL,disease severity,and motor status were assessed by the Nonmotor Symptoms Scale(NMSS),the 39-item Parkinsons Disease Questionnaire(PDQ-39),the modified Hoehn and Yahr staging scale(H&Y)and the Unified Parkinsons Disease Rating Scale part Ⅲ(UPDRS Ⅲ),respectively.We found that 100%of patients with PD presented with NMS.The NMSS significantly correlated with disease duration(Spearmans rS 5 0.276,P 5 0.012),H&Y(rS 5 0.230,P 5 0.038),and UPDRS Ⅲ(rS 5 0.350,P 50.001).Similarly,the PDQ-39 SI significantly associated with the disease duration(rS 5 0.258,P 5 0.019),H&Y(rS5 0.340,P 5 0.002),and UPDRS Ⅲ(rS 5 0.453,P <0.001).NMS domains that influenced the PDQ-39 SI were sleep/fatigue,mood,gastrointestinal,urinary,and miscellaneous symptoms.This strongly suggested that the five domains played a key role in the manifestation of Hr-QoL.NMSS explains more of the variability in Hr-QoL than UPDRS Ⅲ,when both are the model(stepwise multiple linear regression analysis R2 change,47.8%vs.5.87%,respectively).Therefore,these findings demonstrate that NMS are independently and negatively associated with Hr-QoL in PD and that improving NMS should be viewed as an important part in the management of PD.