impaired bed mobility in prediagnostic and de novo Parkinson’s disease

Abstract

Background Wearable technology research suggests that nocturnal movements are disturbed in early Parkinson's disease (PD). In this study, we investigate if patients also already experience impaired bed mobility before PD diagnosis. Furthermore, we explore its association with motor and nonmotor features and its value for phenoconversion and disease progression prediction. Methods PPMI data were downloaded for de novo PD subjects, subjects at-risk for developing a synucleinopathy (with isolated REM sleep behavior disorder, hyposmia or a pathogenic mutation) and controls. Impaired bed mobility was assessed with the MDS-UPDRS part 2 item 9. A frequency analysis was performed. Multivariable logistic regression analyses were used to investigate the association with other PD variables. Cox proportional-hazards models were used to test if difficulties with turning in bed could predict phenoconversion. Linear mixed models were used to evaluate if difficulties with turning in bed could predict disease progression. Results Of the at-risk subjects, 9.2-12.5% experienced difficulties with turning in bed vs. 25.0% of de novo PD subjects and 2.5% of controls. Impaired turning ability was associated with MDSUPDRS motorscore (axial signs in the at-risk group, bradykinesia in the de novo PD group) and SCOPA-AUT score (gastrointestinal symptoms). In addition, difficulties with turning in bed were a significant predictor for phenoconversion in the at-risk group and for development of motor complications in the de novo PD group. Conclusion Our findings suggest that difficulties with turning in bed can be helpful as clinical symptom for a prodromal PD screening and for motor complication prediction in early PD.

Predictors of cognitive impairment in newly diagnosed Parkinson’s disease with normal cognition at baseline: A 5-year cohort study

“…Studies have shown that current diagnoses of diabetes mellitus and hypertension were two important modifiable predictors of cognitive decline in PD (Mollenhauer et al, 2019;Nicoletti et al, 2021;Athauda et al, 2022). Baseline global cognitive function, hyposmia, rapid eye movement (REM) sleep behavior disorder (RBD), dysautonomia, apolipoprotein (APO) E status, β-glucocerebrosidase gene (GBA) status, and dopamine deficit on dopamine transporter (DAT)-imaging have all been suggested as predictors of MCI or dementia in patients with PD (Hu et al, 2014;Mata et al, 2014;Liu et al, 2017;Schrag et al, 2017;Leta et al, 2021;Barrio et al, 2022;Dijkstra et al, 2022). Varieties of studies have explored the association of serum uric acid and cerebral spinal fluid (CSF) findings, however, the results were still controversial (Liu et al, 2015;Pellecchia et al, 2016;Terrelonge et al, 2016;Johar et al, 2017;Seifar et al, 2022).…”