Baseline predictors of progression of Parkinson\u2019s disease in a sample of Egyptian patients: clinical and biochemical

Asmaa Helmy,Mohamed Salama,Eman Hamid,Mahmoud El-Belkimy,Ali Shalash,Ahmed Gaber

doi:10.1186/s41983-022-00445-1

Abstract

BackgroundClinical progression of Parkinson’s disease (PD) is highly heterogeneous, and its predictors are generally lacking. Identifying predictors of early disease progression is important for patients’ management and follow-up. The current study aims to identify clinical, neuroimaging and biochemical baseline predictors of motor progression in patients with PD. Forty-five PD patients were assessed at baseline, 6 months and 1 year using MDS-UPDRS total and subscores, Hoehn and Yahr (H&Y), Schwab and England (S&E), International Physical Activity Questionnaire (IPAQ). Baseline New Freezing of Gait Questionnaire (NFOG-Q), Berg Balance Scale (BBS), Ten-Meter Walking Test (10-MWT), and Time Up and Go Test (TUG), Non-Motor Symptoms Scale (NMSS), Beck Depression Inventory (BDI), PD questionnaire 39 (PDQ-39), MRI brain, uric acid, lipid profile and glycated hemoglobin were performed.ResultsSignificant worsening of MDS-UPDRS total, part III scores, H&Y, S&E and IPAQ (p < 0.001) was detected. One-year progression of H&Y and S&E were significantly correlated to disease duration (p = 0.014, p = 0.025, respectively). Progression of H&Y was correlated to baseline TUG (p = 0.035). S&E progression was correlated to baseline MDS-UPDRS total score (rho = 0.478, p = 0.001) and part III (rho = 0.350, p = 0.020), H&Y (rho = 0.401, p = 0.007), PIGD (rho = 0.591, p < 0.001), NFOG-Q (rho = 0.498, p = 0.001), and TUG (rho = 0.565, p = 0.001). Using linear regression, there was no predictors of clinical progression among the used baseline variables.ConclusionDespite the significant motor and physical activity progression over 1 year that was correlated to baseline motor and gait severity, but without predictive value, further similar and longitudinal studies are warranted to detect predictors of early progression and confirm findings.

Highlights

Clinical progression of Parkinson’s disease (PD) is highly heterogeneous, and its predictors are gener‐ ally lacking
We assessed the predictors of motor progression of PD over 1 year either clinical, neuroimaging or biochemical (serum uric acid, lipid profile, glycated hemoglobin (HbA1c)). In this prospective cohort study, a convenient sample of 75 recruited patients diagnosed with PD according to International Parkinson and Movement Disorders Society (MDS) diagnostic criteria [8], out of them, 45 patients completed the assessments at baseline, 6 months and after 1 year
Comprehensive medical history, neurological examination, laboratory testing, as well as brain imaging were done initially, followed by assessment scales at baseline, 6 months, and at 1 year. They included motor assessment using MDS-Unified Parkinson’s Disease Rating Scale (UPDRS) during OFF state, Hoehn and Yahr, Schwab and England Activities of Daily Living Scale [9], baseline gait assessment during OFF state by New Freezing of Gait Questionnaire (NFOG-Q) [10], Berg Balance Scale (BBS) [11], 10-Meter Walking Test (10-MWT) [12] and Time Up and Go Test (TUG) [13]; physical activity through International Physical Activity Questionnaire short form (IPAQ) [14], baseline assessment of nonmotor symptoms using the Non-Motor Symptoms Scale (NMSS) [15]; depression assessment by the Arabic version of Beck Depression Inventory (BDI) [16], as well as quality of life testing using the Arabic version of PD questionnaire 39 (PDQ-39) [17]; and cognitive assessment at baseline was done by Mini-Mental State Examination (MMSE) [18]

Summary

Introduction

Clinical progression of Parkinson’s disease (PD) is highly heterogeneous, and its predictors are gener‐ ally lacking. Identifying predictors of early disease progression is important for patients’ management and follow-up. The current study aims to identify clinical, neuroimaging and biochemical baseline predictors of motor progression in patients with PD. Clinical progression is highly heterogeneous across individuals, and. Most studies on the annual rate of changes of motor symptoms in early PD show large inter-individual variation, even in the first year of observation, pointing towards different progression trajectories [4]. As reported in smaller studies with a small number of parameters, the most important predictors for worse motor progression are age and motor disability at baseline [5].

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Discussion

Conclusion