Objective: MDS has published the research criteria for prodromal Parkinson’s disease (PD). This study is to estimate the likelihood ratios (LR) of prodromal diagnostic markers of PD based on the published data for Chinese.

Background: Neurodegeneration in PD starts years before the clinical diagnosis can be reliable made, the prodromal stage of PD can be critical for investigating the development of disease and evaluating disease-modifying therapies. The first research criteria to identify prodromal PD were published by MDS in 2015, which used the prior probability and LRs to quantify of the individual risk of PD. The MDS LRs could potentially vary from the LRs of Chinese population (C-LR) due to differences in genetic background and living habits.

Methods: We searched the PubMed and China National Knowledge Infrastructure from January 1st, 1989 to September 18th, 2015 to identify meta-analyses, cohort studies and case-control studies, aimed to investigate the associations of history of environmental exposures, genetic markers and prodromal markers with PD. Data from eligible studies were extracted and used in the estimation of the positive and negative LRs of markers. The set of LRs were applied in 1799 PD patients of the Chinese Parkinson Study Group Cohort retrospectively to estimate the individual risk of PD before diagnosis. Data of the history and pre-diagnostic symptoms of the cohort was reported in the MDS Congress 2017.

Results: Overall, data from 23 studies on different markers were extracted. Meta-analyses were done on the markers without reliable systematic reviews for Chinese population; the markers included coffee (OR = 0.83, 95%CI 0.21~3.34, I2 = 88%), hyperuricemia (OR = 0.50, 95%CI 0.12~2.16, I2 = 96%) and dairy products (OR = 1.71, 95%CI 1.29~2.26, I2 = 0%). The C-LRs of environmental markers were similar to that of the MDS LRs, while C-LRs of genetic markers such as LRRK2 G2385R (LR+ = 2.41) and R1628P (LR+ = 1.95) were first reported in the current study. In our retrospective study, individual LRs increased time-dependently while approaching the clinical diagnosis of PD (P < 0.001), however, only 207 (11.51%) participants fulfilled the criteria of probable prodromal PD one year before diagnosis using the MDS cut-off scores.

Conclusions: The C-LRs of prodromal diagnostic markers were established based on Chinese data and further validation of the complemented criteria need to be done in community-based prospective cohorts.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/likelihood-ratios-of-prodromal-diagnostic-markers-for-chinese-parkinsons-disease-a-systematic-review-and-meta-analysis/