A new study found that factors that may predict the progression of Parkinson’s disease (PD) can be detected at the time of diagnosis. In particular, cardiovascular risk factors such as hypertension and diabetes, as well as elevated uric acid and inflammatory markers are associated with the progression of PD within four years.
The progression of PD and the response to medications vary from individual to individual, making predicting the course of the disease challenge. Current research indicates that the most important risk factors for progression include age at baseline and the extent of motor symptoms. However, to date, most studies on predicting the progression of Parkinson’s disease (PD) have been small and only a few limited factors have been evaluated.
Therefore, in order to study a larger patient population, scholars from Germany, Brit Mollenhauer et al. conducted a study by De Novo Parkinson (DeNoPa). This single-center study was conducted in Kassel, Germany, from 2009 to 2012. A total of 135 patients aged 40-85 years who were diagnosed with PD in the past 6 months were enrolled and 109 healthy controls were included. By.
The researchers used the dyskinesia association’s unified Parkinson’s Disease Rating Scale III (MDS-UPDRS-III) and the Mini-Mental State Examination Scale (MMSE) to assess the annual rate of motor symptoms. At the same time, 44 baseline indicators for predicting PD progression were also studied, including sociodemographics, comorbidities, motor/non-motor symptoms, sleep problems, MRI findings, serum and cerebrospinal fluid biomarkers at 24 and 48 months. A follow-up assessment was performed.
The main findings show that:
Baseline predictors of PD-specific motor progression: male (p = 0.11), coronary heart disease (CAD, p = 0.019), elevated systolic blood pressure (p = 0.030) and diastolic blood pressure (p = 0.090), serum uric acid elevation High (p = 0.04).
Baseline predictors of PD-specific cognitive decline: elevated C-reactive protein (CRP) (p = 0.003), elevated fasting glucose (p = 0.005), and elevated glycosylated hemoglobin (HbA1c, p = 0.02).
The researchers said that although their study was observational and exploratory, in the early stages of PD, patients should be told that they need to immediately begin to reduce their cardiovascular risk factors, including a control to optimal blood pressure and type 2 diabetes. It is recommended that clinicians should pay attention to patient lifestyle interventions, including nutrition and physical activity during middle age, even before the onset of PD.
The researchers also pointed out that the above predictors may be related to each other. Urate is an important natural antioxidant, and high levels of urate are associated with an increased incidence of cardiac metabolic diseases such as hypertension, coronary heart disease, metabolic syndrome, obesity, and insulin resistance. These diseases are usually associated with inflammation. Elevated CRP is a marker of increased inflammation and is associated with a decrease in life expectancy and death of PD.
However, the study was observational and it was not possible to determine why these predictors might be involved in PD progression. Several of the above factors related to PD progression require further study. This includes studying the role of protein aggregation in the progression of PD; how medical diseases such as diabetes cause neuroprotective drug failure, and whether interventions that reduce the risk of CV improve PD progression.