Objective: To investigate the relationship between vascular comorbidity and non-motor symptoms in Parkinson’s Disease (PD) patients.

Background: Previous studies suggested a significant association between the presence of vascular comorbidity and obstructive sleep apnea (OSA) and the severity of motor symptoms and cognitive impairment in PD but few studies have assessed the entire spectra of non-motor symptoms.

Method: Patients were assessed at baseline and 4 years later with the Non-Motor Symptom Assessment Scale (NMSS), Parkinson’s Psychosis Questionnaire (PPQ), UPDRS, MoCA and Apathy scale. After tetrachoric correlation matrix, we conducted linear regression models (adjusted for age, gender, disease duration and UPDRS-III) to investigate the relationship between vascular comorbidity and non-motor symptoms in PD patients.

Results: In 73 PD patients (mean disease duration 7.1 (5.3)), 57% had hypertension, 44% BMI>25, 44% elevated cholesterol, 15% diabetes, 15% OSA, 14% cigarette-smoking history, 8% prior stroke and 8% coronary disease. Tetrachoric correlation matrix analysis showed that vascular comorbidity appeared frequently in combination in our cohort: Factor A (history of diabetes, cholesterol or hypertension), Factor B (history of BMI>25 or cigarette-smoking), Factor C1 (history of coronary disease or stroke), Factor C2 (presence of OSA). Worsening of non-motor symptoms at 4-year follow-up in our group analysis was significant regarding cognition, psychotic symptoms, urinary function and miscellaneous domains. OSA (Factor C2) was significantly associated with higher severity of hallucinations/illusions at baseline (NMSS4, β=2.722, p=0,005 and PPQ-B, β=1.773, p=0,003) and with a worse deterioration of attention/memory (NMSS5, β=8.859, p=0,015), psychotic symptoms (PPQ-B, β=1.637, p=0.014 and PPQ-C, β=1.873, p=0.026) and apathetic mood (Apathy scale, β=6.906, p=0.046) at the 4-year follow-up. At baseline, but not at follow-up, Factor A was negatively associated with miscellaneous domain scores and Factor C1 with autonomic function scores (gastrointestinal tract and urinary function domains).

Conclusion: Vascular comorbidity is frequent in PD patients. Among PD-associated comorbidities, OSA was the main factor of decline. In addition to cognitive impairment, OSA might also potentially worse psychotic symptoms and apathy. Treatment of OSA could be a strategy to help improve these important NMS.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/obstructive-sleep-apnea-and-other-vascular-risk-factors-impact-on-non-motor-symptoms-in-parkinsons-disease/