Subclinical Liver Fibrosis is Associated with More Rapid Cognitive Decline in Parkinson’s Disease (P7-11.013)

Abstract

<h3>Objective:</h3> To determine the impact of liver fibrosis on motor scores and cognition in Parkinson’s disease. <h3>Background:</h3> It is increasingly apparent that even subclinical liver fibrosis is associated with cognitive impairment and frailty. However, it’s impact on motor and cognitive performance in Parkinson’s Disease (PD) is not well understood. <h3>Design/Methods:</h3> We conducted a retrospective cohort study using the Parkinson’s Progression Marker Initiative (PPMI), a longitudinal study collecting data on PD patients. Our exposure was liver fibrosis at baseline, based on the validated Fibrosis-4 (FIB4) score calculated using age, platelet count, aspartate and alanine aminotransferase values. We dichotomized participants as high (≥1.3) versus low (&lt;1.3) FIB4. Our outcomes were the Montreal Cognitive Assessment (MoCA) and Unified Parkinson’s Disease Rating Scale part III (UPDRSIII) on-and off-treatment scores. We used linear mixed models to assess the relationships between FIB4 at baseline and MoCA and UPDRSIII scores, both at baseline and over time during the eight years of available follow-up data. Models were adjusted for demographics, comorbidities, and alcohol use. <h3>Results:</h3> In adjusted models, UPDRSIII on-treatment and off-treatment scores were not significantly different at baseline or over time when comparing participants with high versus low FIB4. High FIB4 score was not associated with low MoCA scores at baseline. However, MoCA scores in the high FIB4 group declined more over time, with an average difference in rate of change of 0.13 (95% CI, 0.06–0.20). This relationship was maintained after adjusting for potential confounders, with a difference in rate of change of 0.12 (95% CI, 0.05–0.20). <h3>Conclusions:</h3> In PD, a high liver fibrosis score was not associated with motor progression but was associated with faster cognitive decline. Liver health may therefore be an under-appreciated determinant of cognitive outcomes in PD. <b>Disclosure:</b> Dr. Zolin has nothing to disclose. Miss Zhang has nothing to disclose. Dr. Ooi has nothing to disclose. Dr. Sarva has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Neurocrine. Dr. Sarva has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novo Nordisk. Dr. Sarva has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bluerock Therapeutics. The institution of Dr. Sarva has received research support from Insightec. The institution of Dr. Sarva has received research support from NeuroNext. The institution of Dr. Sarva has received research support from Neuroderm. The institution of Dr. Sarva has received research support from Covance. The institution of Dr. Sarva has received research support from Prevail. The institution of Dr. Sarva has received research support from Bluerock Therapeutics. The institution of Dr. Sarva has received research support from Biogen. The institution of Dr. Sarva has received research support from Roche. Dr. Kamel has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for JAMA Neurology. Dr. Kamel has received personal compensation in the range of $50,000-$99,999 for serving as a Endpoint adjudication committee with Boehringer-Ingelheim. Dr. Parikh has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for cases of neurological illness. The institution of Dr. Parikh has received research support from Leon Levy Foundation. The institution of Dr. Parikh has received research support from Florence Gould Foundation. The institution of Dr. Parikh has received research support from NY State Empire Clinical Research Investigator Program. The institution of Dr. Parikh has received research support from NIA. The institution of Dr. Parikh has received research support from Medtronic.