Statins in Parkinson’s Disease: Influence on Motor Progression

Abstract

Background: It has been speculated that stains are neuroprotective and are associated with a reduced risk of Parkinson’s disease (PD), but only a few studies have investigated the influence of statins on the progression of PD. Objective: To evaluate whether long-term statin use may affect motor progression in a large cohort of de novo patients with PD. Methods: We conducted a 4-year retrospective observational cohort study to assess patients with PD. The patients were consecutively recruited from a single tertiary center between January 2015 and January 2017. Information on motor function was obtained using the MDS-Unified Parkinson Disease Rating Scale (UPDRS)-III and all subjects were extensively characterized, including information about lifestyle habits, cardiovascular risk factors and cholesterol blood levels. Results: Of the 181 participants included in the study, 104 patients were evaluated for eligibility (42 patients were exposed to statin therapies and 62 were not treated with statins). They presented similar scores in UPDRS III at baseline but the statin users had a lower motor impairment at 4 years compared to non-user PD patients. Additionally, statin treatment resulted in slower progression of the rigidity score of UPDRS over 4 years. No other significant differences were observed between PD patients with and without statins. Conclusion: Early PD patients with long-term statin usage showed lower motor deterioration after 4 years of disease duration compared with patients not taking statins at diagnosis, suggesting a possible influence of statins on disease progression in PD. Further investigation is warranted to understand the potential beneficial effects of statin treatment on clinical symptoms in PD.

Pros and cons for statins use and risk of Parkinson's disease: An updated perspective

“…As well, statins improve the regeneration of dopaminergic neurons and upregulate dopamine transporters 58,59 . Palermo et al 55 revealed statins use for more than 4 years in PD patients reduce the risk of motor deterioration compared to PD patients' non‐used statins. Microglia are the primary innate immune system cells in the central nervous system (CNS).…”

“…54 A retrospective study involved 181 participants, 104 were evaluated (42 patients on statins and 62 were not on statins) revealed that prolonged use of statins for >4 years reduces the incidence of motor development. 55 This study proposed that statins have a neuroprotective role against the development of motor symptoms in PD. A systematic review and meta-analysis comprised 10 published studies confirmed the protective effects of statins against the development of PD.…”

Statin Use and Incidence of Parkinson's Disease in Women from the French E3N Cohort Study

“…The inverse association between statin use and PD raises the question of potential benefits in terms of disease modification in PD patients. In a 4‐year retrospective study (N = 104), statin users had slower progression in Movement Disorder Society–Sponsored Revision of the Unified Parkinson's Disease Rating Scale (MDS‐UPDRS) Part III score and rigidity subscore than nonusers; this finding was driven by lipophilic statins, but the number of PD patients on hydrophilic statins was small 40 . Another study (N = 125) showed faster PD progression (MDS‐UPDRS Part I, imaging markers) for 18 months in hydrophilic statin users compared with nonusers, but not for lipophilic statins 41 .…”

A Possible Role for HMG-CoA Reductase Inhibitors and Its Association with HMGCR Genetic Variation in Parkinson’s Disease

“…Moreover, longitudinally, patients medicated with lipophilic statins declined slower in Dementia Rating Scale-2 (DRS) than non-statin users. In a recent prospective study, statins also have shown protective effect against motor symptoms progression, with the highest impact on rigidity [68].…”