Objective: To explore the relationship of clinical phenotypes of Parkinson’s disease (PD) with vitamin D levels in Veterans diagnosed with PD.

Background: PD is a heterogeneous neurodegenerative disorder in clinical presentation and progression. Etiology underlying phenotypic variation is not clear. Studies have shown that vitamin D deficiency is more prevalent in PD as compared to Alzheimer’s dementia and healthy controls. It has been linked to postural instability and cognitive decline in individuals with PD. However, observations about influence of vitamin D levels on PD clinical expression are inadequate. Here, we studied the effects of vitamin D levels on PD phenotype at its onset. 

Methods: This retrospective cohort study used data from Houston’s Parkinson’s Disease Research, Education and Clinical Center (PADRECC) database from 2001 to 2014. 1327 charts with ICD-9-CM code 332.0 (PD) were queried for laboratory analysis of vitamin D levels. Vitamin D levels were available for 127 patients. Diagnosis of PD as per UK Brain Bank Criteria was confirmed in 68 patients. Clinical features at initial presentation of PD were extracted along with data regarding subsequent progression.

Results: 25 patients had vitamin D levels below 30ng/ml (25-OH vitamin D reference range: 30-100 ng/ml), while 43 patients had levels above 30ng/ml (36.85% vs 63.2%). 20 patients had tremor at initial presentation in vitamin D deficiency group, while 30 patients were noted to have tremor in group with normal vitamin D levels (p=0.35).  Bradykinesia was noted in 18 patients at the time of initial presentation in vitamin D deficient group and in 26 patients with normal vitamin D levels (p=0.26). Rigidity, at initial presentation, was noted in 20 and 34 patients in vitamin D deficient and normal groups, respectively (p=1.0). Postural instability was observed in 12 patients with vitamin D deficiency and 15 patients with normal levels (p=0.33).

Conclusions: In this sample of Veteran population, distribution of PD clinical phenotypes was same across groups with normal and low vitamin D levels.

References: 1.Evatt ML, Delong MR, Khazai N, Rosen A, Triche S, Tangpricha V. Prevalence of vitamin D insufficiency in patients with Parkinson disease and Alzheimer disease. Archives of Neurology 2008;65:1348-1352.

2.Evatt ML. Parkinson disease: Low vitamin D and Parkinson disease-a causal conundrum. Nature Reviews Neurology 2014;10:8-9.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/vitamin-d-and-clinical-phenotypes-of-parkinsons-disease/