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Erschienen in: Clinical Autonomic Research 6/2022

03.09.2022 | Research Article

Selected autonomic signs and symptoms as risk markers for phenoconversion and functional dependence in prodromal Parkinson’s disease

verfasst von: Cameron Miller-Patterson, Jesse Y. Hsu, Lana M. Chahine, James F. Morley, Allison W. Willis

Erschienen in: Clinical Autonomic Research | Ausgabe 6/2022

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Abstract

Purpose

To determine whether dysautonomia can stratify individuals with other prodromal markers of Parkinson’s disease (PD) for risk of phenoconversion and functional decline, which may help identify subpopulations appropriate for experimental studies.

Methods

Data were obtained from Parkinson’s Progression Markers Initiative. Cohorts without PD but with at-risk features were included (hyposmia and/or rapid-eye-movement-sleep behavior disorder, LRRK2 gene mutation, GBA gene mutation). Dysautonomia measures included Scales-for-Outcomes-in-Parkinson’s-Disease Autonomic (SCOPA-AUT), seven SCOPA-AUT subscales, and cardiovascular dysfunction (supine hypertension, low pulse pressure, neurogenic orthostatic hypotension). Outcome measures were phenoconversion and Schwab-and-England Activities-of-Daily-Living (SE-ADL) ≤ 70, which indicates functional dependence. Cox proportional-hazards regression was used to evaluate survival to phenoconversion/SE-ADL ≤ 70 for each dysautonomia measure. If a significant association was identified, a likelihood-ratio test was employed to evaluate whether a significant interaction existed between the measure and cohort. If so, regression analysis was repeated stratified by cohort.

Results

Median follow-up was 30 months. On multivariable analysis, gastrointestinal and female sexual dysfunction subscales were associated with increased risk of phenoconversion, while the cardiovascular subscale and neurogenic orthostatic hypotension were associated with increased risk of SE-ADL ≤ 70; respective hazard ratios (95% confidence intervals) were 1.13 (1.01–1.27), 3.26 (1.39–7.61), 1.87 (1.16–2.99), 5.45 (1.40–21.25). Only the association between the cardiovascular subscale and SE-ADL ≤ 70 was modified by cohort.

Conclusions

Symptoms of gastrointestinal and female sexual dysfunction predict phenoconversion in individuals with other risk markers for PD, while signs and symptoms of cardiovascular dysfunction may be associated with functional decline.
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Metadaten
Titel
Selected autonomic signs and symptoms as risk markers for phenoconversion and functional dependence in prodromal Parkinson’s disease
verfasst von
Cameron Miller-Patterson
Jesse Y. Hsu
Lana M. Chahine
James F. Morley
Allison W. Willis
Publikationsdatum
03.09.2022
Verlag
Springer Berlin Heidelberg
Erschienen in
Clinical Autonomic Research / Ausgabe 6/2022
Print ISSN: 0959-9851
Elektronische ISSN: 1619-1560
DOI
https://doi.org/10.1007/s10286-022-00889-8

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