Contrast sensitivity impairment in drug-naïve Parkinson’s disease patients associates with early cognitive decline

Abstract

Objectives

To investigate the contrast sensitivity function in drug-naïve Parkinson’s disease (PD) patients and its predictive value with longitudinal follow-up data.

Methods

We included newly diagnosed non-demented PD patients who performed contrast sensitivity test between 2013 and 2014. Contrast sensitivity function at drug-naïve state in PD patients was compared with age-matched normal control data of our center. Correlation between contrast sensitivity function and parkinsonian motor and non-motor features including the Mini-Mental State Exam (MMSE) score at the time of diagnosis were analyzed by linear regression. With longitudinal follow-up data after initiating anti-parkinsonian therapy, the risk conferred on subsequent visual hallucinations and cognitive impairment requiring anti-dementia drugs was analyzed by dichotomizing PD group based on the initial contrast sensitivity function.

Results

Forty-eight patients were finally included, and mean follow-up periods were 43 months. Contrast sensitivity function in drug-naïve PD patients was significantly worse than controls. Contrast sensitivity function correlated with sleep disturbance (p = 0.001) and global cognitive status reflected by the MMSE score (p = 0.020). It also associated with further decline in the MMSE during the follow-ups (p = 0.029). Patients with below average contrast sensitivity function at the time of diagnosis showed higher risk of cognitive decline requiring anti-dementia drugs (adjusted odds ratio = 4.68, p = 0.04) and of visual hallucinations (adjusted odds ratio = 12.54, p = 0.04) than those above average function during the follow-up.

Conclusion

Contrast sensitivity impairment in drug-naïve PD patients associates with clinical demand for therapeutic intervention of cognitive decline as well as development of visual hallucinations in the early course of the disease.

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Funding

This work was supported by a National Research Foundation (NRF) grant funded by the Ministry of Education, Science and Technology (MEST) in Korea (NRF-2018R1C1B3008971) and by a clinical research grant-in-aid from the Seoul Metropolitan Government-Seoul National University (SMG-SNU) Boramae Medical Center (03–2015-8).

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Correspondence to Jee-Young Lee.

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SB Hong, J.-Y. Lee, J. Ahn, D Yoo, JY Shin, and B. Jeon report there are no potential conflict of interest related to this work.

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Hong, S.B., Ahn, J., Yoo, D. et al. Contrast sensitivity impairment in drug-naïve Parkinson’s disease patients associates with early cognitive decline. Neurol Sci 41, 1837–1842 (2020). https://doi.org/10.1007/s10072-020-04289-6

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Keywords

  • Parkinson’s disease
  • Contrast sensitivity
  • Cognition