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Predicting Progression in Parkinson's Disease Using Baseline and 1-Year Change Measures
Journal article   Open access   Peer reviewed

Predicting Progression in Parkinson's Disease Using Baseline and 1-Year Change Measures

Lana M Chahine, Andrew Siderowf, Janel Barnes, Nicholas Seedorff, Chelsea Caspell-Garcia, Tanya Simuni, Christopher S Coffey, Douglas Galasko, Brit Mollenhauer, Vanessa Arnedo, …
Journal of Parkinson's disease, Vol.9(4), pp.665-679
10/11/2019
DOI: 10.3233/JPD-181518
PMCID: PMC6839498
PMID: 31450510
url
https://doi.org/10.3233/JPD-181518View
Published (Version of record) Open Access

Abstract

Background: Improved prediction of Parkinson's disease (PD) progression is needed to support clinical decision-making and to accelerate research trials. Objectives: To examine whether baseline measures and their 1-year change predict longer-term progression in early PD. Methods: Parkinson's Progression Markers Initiative study data were used. Participants had disease duration ≤2 years, abnormal dopamine transporter (DAT) imaging, and were untreated with PD medications. Baseline and 1-year change in clinical, cerebrospinal fluid (CSF), and imaging measures were evaluated as candidate predictors of longer-term (up to 5 years) change in Movement Disorders Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) score and DAT specific binding ratios (SBR) using linear mixed-effects models. Results: Among 413 PD participants, median follow-up was 5 years. Change in MDS-UPDRS from year-2 to last follow-up was associated with disease duration (β= 0.351; 95% CI = 0.146, 0.555), male gender (β= 3.090; 95% CI = 0.310, 5.869), and baseline (β= -0.199; 95% CI = -0.315, -0.082) and 1-year change (β= 0.540; 95% CI = 0.423, 0.658) in MDS-UPDRS; predictors in the model accounted for 17.6% of the variance in outcome. Predictors of percent change in mean SBR from year-2 to last follow-up included baseline rapid eye movement sleep behavior disorder score (β= -0.6229; 95% CI = -1.2910, 0.0452), baseline (β= 7.232; 95% CI = 2.268, 12.195) and 1-year change (β= 45.918; 95% CI = 35.994,55.843) in mean striatum SBR, and 1-year change in autonomic symptom score (β= -0.325;95% CI = -0.695, 0.045); predictors in the model accounted for 44.1% of the variance. Conclusions: Baseline clinical, CSF, and imaging measures in early PD predicted change in MDS-UPDRS and dopamine-transporter binding, but the predictive value of the models was low. Adding the short-term change of possible predictors improved the predictive value, especially for modeling change in dopamine-transporter binding.
Biomarkers Brain Brain Disorders Aged Biochemistry and Cell Biology Clinical Research Disease Progression Dopamine Plasma Membrane Transport Proteins Female Humans Male Middle Aged Neurodegenerative Neurological Neurosciences Parkinson Disease Parkinson's disease Prospective Studies Severity of Illness Index surrogate endpoint The Parkinson’s Progression Markers Initiative

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