Objective: To analyze the correlation between the use of beta-blockers (BB) and the prevalence of non-motor symptoms in patients with Parkinson’s disease (PD).

Background: In a prior study [1] we found that BB are associated with a lower risk of constipation in PD. Therefore, we further assessed the association of BB with other non-motor symptoms in a larger population of PD patients.

Method: We conducted a retrospective review of 500 PD patients attending the Movement Disorders clinic at Cedars Sinai Medical Center between 2010 and 2015. Vitals, medications, motor and non-motor symptoms were collected. Data was analyzed using an Excel spreadsheet. Active treatment with BB was correlated with the subjective report of PD-related non-motor symptoms including anxiety, apathy, attention deficits, constipation, depression, fatigue, forgetfulness, hyperhidrosis, hyposmia, nocturia, orthostatic hypotension, pain, REM behavior disorder, sleep fragmentation, urinary urgency, visual hallucinations, weight loss. Chi square test was used to compare pairs of categorical variables. A p value <0.05 was used to determine statistical significance.

Results: A large number of PD patients in our population (298/485, 61%) reported constipation. Of these 36/84 (43%) were on BB and 262/401 (65%) were not (Chi square, p<0.01). Other non-motor symptoms that appeared to be modulated by BB therapy, albeit not reaching statistical significance, were decreased attention and apathy. Overall, 166/479 patients (34%) reported decreased attention, of which 21/81 (25%) were on BB and 145/398 (36%) were not. Similarly, 148/456 patients (32%) reported apathy, of which 19/78 were in the BB group (24%) and 129/378 (34%) were not. No other non-motor symptom appeared to show a significant relationship with adrenergic blocker therapy.

Conclusion: As previously reported, BB have a significant effect on reducing constipation, and may also have an effect on apathy and attention in PD patients. While this study is limited by the retrospective nature of the investigation and the subjective report of symptoms, it is of interest that the three symptoms that appear modulated by BB treatment are associated with adrenergic activity. Further investigation will be needed to assess the association between modulating adrenergic activity and non-motor PD.

References: [1] Pagano, G., Tan, E. E., Haider, J. M., Bautista, A., & Tagliati, M. (2015). Constipation is reduced by beta-blockers and increased by dopaminergic medications in Parkinson disease. Parkinsonism & Related Disorders,21(2), 120-125. doi:10.1016/j.parkreldis.2014.11.015

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MDS Abstracts - https://www.mdsabstracts.org/abstract/adrenergic-receptor-modulation-of-non-motor-symptoms-in-parkinsons-disease/