scholarly journals Does Serum Urate Change as Parkinson’s Disease Progresses?

2020 ◽  
Vol 10 (4) ◽  
pp. 1571-1576
Author(s):  
Yasemin G. Hasimoglu ◽  
Xiqun Chen ◽  
Rachit Bakshi ◽  
Michael A. Schwarzschild ◽  
Eric A. Macklin

Higher serum urate concentration is associated with decreased risk of Parkinson’s disease (PD) as well as slower disease progression, but its relationship with severity of PD remains unclear. This study investigated whether changes in serum urate concentration over 5 years were associated with disease progression assessed by MDS-UPDRS Part III score, Hoehn and Yahr stage, or DaTscan imaging. Average serum urate concentration was stable over time and change in serum urate concentration did not correlate with worsening of measures of PD progression. These results suggest that serum urate concentration is not a monitoring biomarker of PD progression in early stages.

2021 ◽  
Author(s):  
Dilan Athauda ◽  
James Evans ◽  
Anna Wernick ◽  
Gurvir Virdi ◽  
Minee Liane-Choi ◽  
...  

Importance: Type 2 diabetes (T2DM) is an established risk factor for developing Parkinson's disease (PD) but its effect on disease progression is not well understood. Objective: To examine the effects of co-morbid T2DM on Parkinson's disease progression and quality of life. Design: We analysed data from the Tracking Parkinson's study, a large multi-centre prospective study in the UK. Participants: The study included 1930 adults with recent onset PD, recruited between February 2012 and May 2014, and followed up regularly thereafter. Exposure: A diagnosis of pre-existing T2DM was based on self-report at baseline. After controlling for confounders, an evaluation of how T2DM affects PD was performed by comparing symptom severity scores; and analyses using multivariable mixed models was used to determine the effects of T2DM on Parkinson's disease progression. Main Outcomes and Measures: The impact of T2DM on Parkinsons disease severity was derived from scores collected using the Movement Disorders Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS), Non-Motor Symptoms Scale (NMSS), Montreal Cognitive Assessment (MoCA), Questionnaire for impulsive-compulsive disorders in PD (QUIP), Leeds Anxiety and Depression Scale (LADS), and Schwab and England ADL scale. Results: We identified 167 (8.7%) patients with PD and T2DM (PD+T2DM) and 1763 (91.3%) with PD without T2DM (PD). Patients with T2DM had more severe motor symptoms, as assessed by MDS-UPDS III 25.8 (0.9) vs 22.5 (0.3) p=0.002, had significantly faster motor symptom progression over time (p=0.012), and T2DM was an independent predictor for the development of substantial gait impairment (HR 1.55, CI 1.07-2.23, p=0.020). Patients were more likely to have loss of independence (OR 2.08, CI 1.34-3.25, p=0.001); and depression (OR 1.62, CI 1.10-2.39, p=0.015), and developed worsening mood (p=0.041) over time compared to the PD group. T2DM was also an independent predictor for the development mild cognitive impairment (HR 1.7, CI 1.24-2.51, p=0.002) over time Conclusions and relevance: T2DM is associated with faster disease progression in PD, highlighting an interaction between these two diseases. As it is a potentially modifiable, metabolic state, with multiple peripheral and central targets for intervention, it may represent a target for ameliorating parkinsonian symptoms, and progression to disability and dementia.


2021 ◽  
pp. 1-12
Author(s):  
Klara Komici ◽  
Grazia Daniela Femminella ◽  
Leonardo Bencivenga ◽  
Giuseppe Rengo ◽  
Gennaro Pagano

Background: A link between diabetes mellitus (DM) and Parkinson’s disease (PD) have been proposed but evidence are sparse and inconsistent. Objective: Perform a systematic review of all evidence that link DM and PD characterising the prevalence of DM in PD patients, the risk of developing PD in DM patients and the influence of DM on PD severity and progression. Methods: MEDLINE, Scopus, and Cochrane Library from inception to June 30, 2021 were searched. Studies reporting prevalence, incidence, severity and disease progression of DM and PD were included. Prevalence of DM in PD and incidence of PD in DM patients, and characteristics of PD. Results: A total of 21 studies (n = 11,396) included data on DM prevalence in PD patients, 12 studies (n = 17,797,221) included data on incidence of PD in DM patients, and 10 studies (n = 2,482) included data on DM impact on PD severity and disease progression. The prevalence of DM in PD patients was 10.02 %, (95%C.I. 7.88 –12.16), DM patients showed a higher risk of developing PD (OR: 1.34 95%CI 1.26–1.43 p <  0.0001) compared to non-DM, and PD patients with DM showed a greater severity of motor symptoms, with higher Hoehn and Yahr stage (SMD: 0.36 95%CI 0.12–0.60; p <  0.001) and higher UPDRS (SMD 0.60 95%CI 0.28–0.92; p <  0.001) compared with PD patients without DM. Conclusion: Although the prevalence of DM in PD patients is similar to the general population, patients with DM have a higher risk of developing PD, and the presence of DM is associated with greater PD severity and faster progression, which suggests that DM may be a facilitating factor of neurodegeneration.


2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Ruwei Ou ◽  
Qianqian Wei ◽  
Yanbing Hou ◽  
Lingyu Zhang ◽  
Kuncheng Liu ◽  
...  

AbstractThis study aimed to explore the effect of pre-existing essential tremor (ET) history on the disease progression of Parkinson’s disease (PD). We recruited and followed-up a group of PD patients from March 2009 to July 2020. The ET history of each patient was obtained by retrospective interviews or past medical records. Cox proportional hazards models with inverse probability of treatment weighting (IPTW) were used to estimate the hazard ratio (HR) with 95% confidence intervals (CIs). Of 785 patients who completed the followed-up visits, 61 patients (7.8%) reported a history of pre-existing ET. Cox regression models after IPTW indicated that the positive ET history in patients with PD was protective against time to United PD Rating Scale III 14-point increase (HR = 0.301, 95% CI = 0.134–0.678, P = 0.004), time to akinesia and rigidity 8-point increase (HR = 0.417, 95% CI = 0.218–0.796, P = 0.008), time to conversion to Hoehn and Yahr stage 3 (HR = 0.356, 95% CI = 0.131–0.969, P = 0.043), time to develop dyskinesia (HR = 0.160, 95% CI = 0.037–0.698, P = 0.015), and time to Montreal Cognitive Assessment 3-point decrease (HR = 0.389, 95% CI = 0.160–0.946, P = 0.037), but had no relationship with time to tremor 4-point increase (HR = 1.638, 95% CI = 0.822–3.266, P = 0.161) and time to death (HR = 0.713, 95% CI = 0.219–2.319, P = 0.574). Our study indicated that ET history in patients with PD is associated with a benign prognosis with slower motor and non-motor progression.


2021 ◽  
Vol 81 ◽  
pp. 307-311 ◽  
Author(s):  
Claudio Liguori ◽  
Valentino De Franco ◽  
Rocco Cerroni ◽  
Matteo Spanetta ◽  
Nicola Biagio Mercuri ◽  
...  

Author(s):  
Hannah L Combs ◽  
Kate A Wyman-Chick ◽  
Lauren O Erickson ◽  
Michele K York

Abstract Objective Longitudinal assessment of cognitive and emotional functioning in patients with Parkinson’s disease (PD) is helpful in tracking progression of the disease, developing treatment plans, evaluating outcomes, and educating patients and families. Determining whether change over time is meaningful in neurodegenerative conditions, such as PD, can be difficult as repeat assessment of neuropsychological functioning is impacted by factors outside of cognitive change. Regression-based prediction formulas are one method by which clinicians and researchers can determine whether an observed change is meaningful. The purpose of the current study was to develop and validate regression-based prediction models of cognitive and emotional test scores for participants with early-stage idiopathic PD and healthy controls (HC) enrolled in the Parkinson’s Progression Markers Initiative (PPMI). Methods Participants with de novo PD and HC were identified retrospectively from the PPMI archival database. Data from baseline testing and 12-month follow-up were utilized in this study. In total, 688 total participants were included in the present study (NPD = 508; NHC = 185). Subjects from both groups were randomly divided into development (70%) and validation (30%) subsets. Results Early-stage idiopathic PD patients and healthy controls were similar at baseline. Regression-based models were developed for all cognitive and self-report mood measures within both populations. Within the validation subset, the predicted and observed cognitive test scores did not significantly differ, except for semantic fluency. Conclusions The prediction models can serve as useful tools for researchers and clinicians to study clinically meaningful cognitive and mood change over time in PD.


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