Biomarkers May Predict Dementia in Parkinson's Disease

the Psychiatry Advisor take:

Differences in biomarkers in cerebrospinal fluid may be useful in the early diagnosis of Parkinson’s disease and PD dementia, and may help in the development of future therapies.

David C. Bäckström, MD, of Umeå University in Sweden, and colleagues set out to assess the diagnostic and prognostic value of a panel of cerebrospinal fluid (CSF) biomarkers in people with idiopathic parkinsonism. The study included a cohort of 128 nondemented patients with new-onset parkinsonism (diagnosed between Jan. 1, 2004 and Apr. 30, 2009): 104 with Parkinson's disease (PD), 11 with multiple system atrophy, and 13 with progressive supranuclear palsy. Samples of CSF were taken from 30 healthy controls for comparison. Participants were followed up with for five to nine years.

CSF was measured for concentrations of neurofilament light chain protein, Aβ1-42, total tau, phosphorylated tau, α-synuclein, and heart fatty acid–binding protein, and all participants underwent an extensive neuropsychological assessment during follow-up.

Researchers found that the 104 patients with PD had a different CSF pattern than the 13 patients with progressive supranuclear palsy and the 30 controls. A CSF pattern marking the development of Parkinson's disease dementia (PDD) was also found. In people with PD, high neurofilament light chain protein, low Aβ1-42, and high heart fatty acid–binding protein at baseline was associated with future PDD diagnosis. 

When combined, the biomarkers predicted PDD with high accuracy (HR, 11.8; 95% CI, 3.3-42.1; P=0.0001) after adjusting for possible confounders.The panel of biomarkers may be used in the future to predict the likelihood of developing PDD in patients with PD.

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The panel of biomarkers may be used in the future to predict the likelihood of Parkinson's disease dementia.

Alterations in cerebrospinal fluid (CSF) have been found in Parkinson's disease (PD) and in PD dementia (PDD), but the prognostic importance of such changes is not well known. In vivo biomarkers for disease processes in PD are important for future development of disease-modifying therapies.

Researchers conducted a regional population-based, prospective cohort study of idiopathic parkinsonism that included patients diagnosed between January 1, 2004, and April 30, 2009, by a movement disorder team at a university hospital that represented the only neurology clinic in the region. 

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