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The contribution of cerebrovascular risk factors, metabolic and inflammatory changes to cognitive decline in Parkinson’s disease: preliminary observations

  • Neurology and Preclinical Neurological Studies - Original Article
  • Published:
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Abstract

To determine whether systemic medical factors, such as vascular risk factors, metabolic and inflammatory markers contribute to cognitive decline in Parkinson’s disease (PD); if confirmed to determine whether a clinically applicable risk factor model can predict the conversion from normal cognition (NC) to mild cognitive impairment (MCI). 58 patients who met the UK Brain Bank Criteria for PD underwent clinical and laboratory assessment at study entry; 47 patients were re-assessed after 2 years. Medical history, vascular risk (QRISK2), blood metabolic and inflammatory factors, brain vessel examinations, activity of daily living, and neuropsychological testing were performed. Forty patients had NC and 18 patients had MCI at baseline. Patients with MCI had higher level of interleukin 6, folic acid below normal range and higher l-dopa equivalent dose compared to cognitive normal patients at baseline. Patients with NC at baseline were classified into two groups: patients who remained cognitively normal (non-converters, n = 23) and patients who progressed to MCI (converters, n = 11). MCI converters were older at baseline and had higher QRISK2 than the non-converters. Patients with higher QRISK2, lower uric acid level and lower activity of daily living scale at baseline had a higher risk of converting from NC to MCI with a sensitivity of 72.2%, a specificity of 87%, and an overall accuracy of 82.4%. Systemic medical factors are associated with cognitive impairment in PD both cross-sectionally and longitudinally. A risk factor model predicting the decline from NC to MCI could be constructed.

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Abbreviations

ACE:

Addenbrooke’s cognitive examination

ADL:

Activity of daily living

AUC:

Area under the curve

BI:

Barthel index

BVRT:

Benton visual retention test

CCA:

Common carotid artery

CDT:

The clock drawing test

CI:

Confidence intervals

IL-6:

Interleukin 6

IMT:

Intimal-medial thickness

MCA:

Medial cerebral artery

MCI:

Mild cognitive impairment

MMSE:

Mini-mental state examination

NC:

Normal cognition

OR:

Odds ratio

PD:

Parkinson’s disease

PDD:

Parkinson’s disease dementia

PD-MCI:

Parkinson’s disease mild cognitive impairment

PI:

Pulsatility index

RI:

Resistance index

ROC:

Receiver operating characteristic

UPDRS:

Unified Parkinson’s disease rating scale

USG:

Ultrasonographic

VFT:

The verbal fluency test (VFT),

WMS:

Wechsler Memory Scale III

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Acknowledgments

Support was provided by the project CEITEC 2020 (LQ1601) and grant AZV 16-33798A. We would like to thank Ján Necpal, M.D., from the Neurology Department, Zvolen, Slovak Republic for kindly referring patients for participation in this study. We also would like to thank to Anne Johnson for grammatical assistance and for reviewing the manuscript.

Funding

Support was provided by the project CEITEC 2020 (LQ1601) and grant Ministry of Health of Czech Republic AZV 16-33798A.

Author information

Authors and Affiliations

  1. Department of Neurology, Faculty Hospital, Constantine the Philosopher University, Nitra, Slovak Republic

    Branislav Veselý

  2. Central European Institute of Technology (CEITEC), Brain and Mind Research Program, Masaryk University, Pekařská 664/53, 656 91, Brno, Czech Republic

    Branislav Veselý, Eva Koriťáková & Ivan Rektor

  3. Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk University, Brno, Czech Republic

    Eva Koriťáková

  4. Departments of Radiology and Neurology, University of Michigan, and Ann Arbor VA Medical Center, Ann Arbor, MI, USA

    Nicolaas I. Bohnen

  5. Department of Neurology, Charles University, Faculty of Medicine, Hradec Králové, Czech Republic

    Daša Viszlayová

  6. Department of Clinical Psychology, Faculty Hospital, Constantine Philosopher University, Nitra, Slovak Republic

    Silvia Királová

  7. Second Department of Neurology, Comenius University School of Medicine, Bratislava, Slovak Republic

    Peter Valkovič

  8. Clinic of Neurology, Comenius University, Jessenius Faculty of Medicine, Martin, Slovak Republic

    Egon Kurča

Authors
  1. Branislav Veselý
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  2. Eva Koriťáková
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  3. Nicolaas I. Bohnen
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  4. Daša Viszlayová
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  5. Silvia Királová
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  6. Peter Valkovič
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  7. Egon Kurča
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  8. Ivan Rektor
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Contributions

(1) Research project: A. conception, B. organization, C. execution; (2) statistical analysis: A. design, B. execution, C. review and critique; (3) manuscript: A. writing of the first draft, B. review and critique. BV: 1A, 1B, 1C, 2C, 3A. EK: 2A, 2B, 2C. VD: 1C. SK: 1C. PV: 3B. EK: 3B. IR: 1A,1B, 1C, 2A, 3B.

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Correspondence to Ivan Rektor.

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Veselý, B., Koriťáková, E., Bohnen, N.I. et al. The contribution of cerebrovascular risk factors, metabolic and inflammatory changes to cognitive decline in Parkinson’s disease: preliminary observations. J Neural Transm 126, 1303–1312 (2019). https://doi.org/10.1007/s00702-019-02043-7

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  • DOI: https://doi.org/10.1007/s00702-019-02043-7

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