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Neuropsychiatric Burden Is a Predictor of Early Freezing and Motor Progression in Drug-Naïve Parkinson's Disease

 Seong Ho Jeong  ;  Han Soo Yoo  ;  Seok Jong Chung  ;  Jin Ho Jung  ;  Yang Hyun Lee  ;  Kyoungwon Baik  ;  Young H Sohn  ;  Phil Hyu Lee 
 JOURNAL OF PARKINSONS DISEASE, Vol.11(4) : 1947-1956, 2021-10 
Journal Title
Issue Date
Parkinson’s disease ; motor prognosis ; neuropsychiatric symptoms
Background: Neuropsychiatric symptoms (NPS) are the most common non-motor symptom in Parkinson's disease (PD).

Objective: To investigate the association between the burden of NPS and motor prognosis in patients with PD.

Methods: We enrolled 329 drug-naïve patients with PD, who was non-demented and followed-up≥2 years after their first visit to the clinic with baseline dopamine transporter (DAT) imaging and neuropsychiatric inventory (NPI) scores. We performed a survival analysis and a linear mixed model analysis to assess longitudinal motor outcomes according to the NPI total score.

Results: The Kaplan-Meier analysis showed no difference in the development of levodopa-induced dyskinesia and wearing-off according to the NPI total score. However, higher burden of NPI total score was associated with earlier freezing of gait (FOG) development in the time-dependent Cox regression models after adjusting for age at symptom onset, sex, disease duration, Unified PD Rating Scale motor score, baseline Mini-Mental State Examination score, DAT activity in the posterior putamen and levodopa-equivalent daily dose (LEDD) (Hazard ratio 1.047, p = 0.002). A linear mixed model analysis revealed that patients with a higher NPI total score had a more rapid LEDD increment (NPI×time, p = 0.003). Among 52 patients with PD who eventually developed FOG during the follow-up period, there was a significant correlation between the NPI total score and time with FOG development (γ= -0.472; p = 0.001) after adjusting for confounding factors.

Conclusion: The present study demonstrated that the severity of NPS is a predictor of early freezing and motor progression in patients with PD.
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1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
Yonsei Authors
Baik, Kyoungwon(백경원) ORCID logo https://orcid.org/0000-0001-7215-375X
Sohn, Young Ho(손영호) ORCID logo https://orcid.org/0000-0001-6533-2610
Yoo, Han Soo(유한수) ORCID logo https://orcid.org/0000-0001-7846-6271
Lee, Yang Hyun(이양현)
Lee, Phil Hyu(이필휴) ORCID logo https://orcid.org/0000-0001-9931-8462
Chung, Seok Jong(정석종) ORCID logo https://orcid.org/0000-0001-6086-3199
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