The present study aimed to survey the prevalence of prodromal symptoms of Parkinson’s disease (PD) in Japanese health checkup examinees, for identifying at-risk subjects.
We conducted a questionnaire survey of annual health checkup examinees without neurological symptoms using the following self-reported questionnaires: Japanese version of the Scale for Outcomes in Parkinson’s disease for Autonomic Symptoms (SCOPA-AUT); Self-administered Odor Question (SAOQ); REM Sleep Behavior Disorder Screening Scale (RBDSQ); Beck Depression Inventory-Second Edition (BDI-II); Epworth Sleepiness Scale (ESS); and Physical Activity Scale for the Elderly (PASE). The presence of prodromal symptoms was determined using the 90th percentile threshold of each questionnaire. Subjects ≥ 50 years of age with ≥ 2 core prodromal symptoms (dysautonomia, hyposmia, and RBD), were classified as at risk.
Between March 2017 and March 2018, 4,953 participants sufficiently answered the questionnaires. Among 2,726 subjects ≥ 50 years of age, 155 were classified as at risk. These subjects had worse values of BDI-II (12.0 ± 8.3 vs. 4.4 ± 3.8, p < 0.001) and ESS (9.6 ± 5.0 vs. 6.3 ± 3.2, p < 0.001), in addition to SCOPA-AUT, SAOQ, and RBDSQ. Male at-risk subjects showed lower values of hemoglobin (14.8 ± 1.3 vs. 15.0 ± 1.1, p = 0.032) and low density lipoprotein cholesterol (114.5 ± 30.3 vs. 123.0 ± 28.9, p = 0.004) than the examinees reporting no prodromal symptoms.
Approximately 6% of the population aged 50 years or older was at risk for PD. Male at-risk subjects had mild hematological and metabolic changes relevant to PD.
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The authors are grateful to all the participants in this study. Dr. Katsuno is supported by a JSPS KAKENHI Grant Number JP17H04195; grants from Japan Agency for Medical Research and Development (Nos. 19ek0109221h0003, 19ek0109359h0002, 19dk0207027h0004, 19lk0201101h0001, and 19dm0107155h0001); a grant from the Naito Foundation; and a grant from the Hori Sciences and Arts Foundation.
This work was funded by The Research Funding for Longevity Sciences (Nos. 28–8 and 19–20) from National Center for Geriatrics and Gerontology (NCGG), Japan; grants from Japan Agency for Medical Research and Development (Nos. 19dk0207027h0004, 19lk0201101h0001, and 19dm0107155h0001); and a grant from the Naito Foundation. Dr. Katsuno is supported by JSPS KAKENHI Grant Number 17H04195, Alnylam Japan, Otsuka Pharmaceutical Co. Ltd., Daiichi Sankyo Company Limited, Takeda Pharmaceutical Co. Ltd., Biogen Japan, UCB Japan, and Novartis Pharma K.K., and grants from Dainippon Sumitomo Pharma Co. Ltd., Otsuka Pharmaceutical Co. Ltd., Daiichi Sankyo Company Limited, and CSL Behring K.K. Dr. Suzuki is supported by the Research Funding for Longevity Sciences (Nos. 28-8 and 19-20) from National Center for Geriatrics and Gerontology (NCGG); and a grant from the Japan Foundation For Aging And Health. Dr. Hirakawa is supported by a JSPS KAKENHI Grant Number JP15K15948; grants from Japan Agency for Medical Research and Development (Nos. 19de017004h0001 and 19mk0101169h0001). Dr. Watanabe is supported by Otsuka Pharmaceutical Co. Ltd., Kyowa Hakko Kirin Co. Ltd., Takeda Pharmaceutical Co. Ltd., Dainippon Sumitomo Pharma Co. Ltd., FP Pharmaceutical Corporation, Eisai Co. Ltd., Daiichi Sankyo Company Limited, and Novartis Pharma K.K., and grants from Otsuka Pharmaceutical Co. Ltd. and FUJIFILM RI Pharma Co. Ltd.
Conflicts of interest
Drs. Hattori, Tsuboi, Yokoi, Tanaka, Sato, Arahata, Hori, Kawashima, and Washimi report no disclosures.
This study was conducted in accordance with the 1964 Declaration of Helsinki and its later amendments, the Ethics Guidelines for Human Genome/Gene Analysis Research, and the Ethical Guidelines for Medical and Health Research Involving Human Subjects endorsed by the Japanese government. The study protocol was approved by the Ethics Review Committee of Nagoya University Graduate School of Medicine (No. 2016–0328). All participants provided their written informed consent before participation in the study.
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Hattori, M., Tsuboi, T., Yokoi, K. et al. Subjects at risk of Parkinson’s disease in health checkup examinees: cross-sectional analysis of baseline data of the NaT-PROBE study. J Neurol (2020). https://doi.org/10.1007/s00415-020-09714-6
- Dementia with Lewy bodies
- Risk factors in epidemiology
- All movement disorders
- Parkinson’s disease/parkinsonism