Latest News in Parkinson Disease: Predicting Dementia Onset, Prevalence of Dykinesia and OFF Time, and More

Progression to PD-Related Dementia Predicted by Polygenic Hazard Score

A polygenic hazard score for predicting progression of PD over time to dementia (PDD) was shown in a study published in Nature Genetics that identified 5 genetic loci associated with progression:

• RIMS2 (HR, 4.77; P = 2.78 × 10⁻¹¹)
• MEM108 (HR, 2.86; P = 2.09 × 10⁻⁸)
• WWOX (HR, 2.12; P = 2.37 × 10⁻⁸)
• GBA (HR, 1.93; P = .0002)
• APOE (HR, 1.48; P = .001)

As reported by NeurologyLive^®, GBA and APOE4 loci were indicated to have been associated with PDD previously, whereas the discovery of the other 3 loci had not been previously reported. RIMS2 exhibited a 2.5-times stronger effect on cognitive prognosis than GBA and APOE4, with patients carrying the lead variant found to decline more rapidly over time compared with patients who were noncarriers (P = .0014).

Findings From AAN 2021 Identify Gaps in Access to Device-Aided Therapies for PD

Discussing findings of an abstract presented at the American Academy of Neurology’s (AAN) 73rd Annual Meeting held virtually April 17-22, 2021, lead author Hubert Fernandez, MD, director of the Center for Neurological Restoration at Cleveland Clinic, spoke in an interview with NeurologyLive® on the health inequities present in availability of device-aided therapies (DATs) for patients with PD.

His abstract, “Identifying Gaps in Parkinson Disease Patients Eligible for Device-Aided Therapies,” assessed the eligibility for DATs among those with PD via a validated screening tool called MANAGE-PD.

Grouping patients based on their level of DAT eligibility according to oral therapy efficacy, 19% were inadequately controlled by oral therapy and therefore qualified for DAT, although only half were found to have had discussions with providers on future use of these therapies.

Fernandez spoke further during the interview on the immediacy of this therapeutic approach for patients with PD who are eligible and how accurate screening could prove critical for long-term care.

Patient Survey Finds Dyskinesia, OFF Time as Most Prevalent Symptoms in PD

Another study presented at the AAN 73rd Annual Meeting sought to explore the impact of 2 common symptoms in patients with PD, dyskinesia and OFF time, on both patients and their families and caretakers.

Analyzing data from 775 surveys, which included 527 patients with PD (68%) and 248 care partners (32%), 78% of respondents reported no or moderate understanding of dyskinesia and OFF, according to NeurologyLive®. Moreover, 398 (51%) reported experiencing dyskinesia, 591 (76%) reported experiencing OFF at least occasionally, and 368 (48%) experienced both symptoms.

In examining the prevalence of symptom burden, 86% reported daily issues related to dyskinesia and 90% reported daily OFF issues, with more than half of both patient groups reporting having to change plans or activities due to their symptoms (dyskinesia, 61%; OFF, 60%).

Notably, 32% of those affected by dyskinesia said their symptoms have made social interactions more difficult, whereas 27% of those experiencing OFF symptoms were reported to have feelings of isolation and loneliness.