Objective: To investigate the association of depression with the progression of motor symptoms in patients with early-stage PD.

Background: Depression is a major nonmotor symptom in Parkinson’s disease (PD) and despite it being an important impacting factor on the quality of life of PD patients, it is often overlooked. Depression has been reported to be related to several clinical manifestations of PD. However, the association of depression with the progression of PD is unclear.

Method: The study involved 123 patients who were diagnosed with PD and had remained unexposed to anti-parkinsonian drugs. All subjects underwent a baseline assessment for depression and cognitive function using the geriatric depression scale (GDS) and the Seoul Neuropsychological Screening Battery (SNSB). Subjects were divided into a depressed PD group, and a non-depressed PD group. Analyses were conducted to identify any association of depression at baseline with the progression of the motor symptoms of PD. These were assessed by the progression to Hoehn and Yahr (H-Y) stage 3 and the occurrence of freezing of gait (FOG), levodopa-induced dyskinesia, and wearing-off during 53.42 ± 16.10 months of follow-up evaluations following the baseline assessment.

Results: Depression in drug-naïve, early-stage PD patients showed a significant association with the progression to H-Y stage 3 and the occurrence of FOG in the early stages of PD (HR = 2.60; 95% CI = 1.43–4.71; p =.002 and HR = 23.75; 95% CI = 1.77–[Editor1] 317.98; p = 0.017, respectively), analyzed by Cox regression analyses. These significant associations remained in analyses using Kaplan–[Editor2] Meier curves (Log-rank p = 0.001 and 0.007, respectively). In contrast, depression among drug-naïve, early-stage PD patients was not associated with the occurrence of levodopa-induced dyskinesia (p = 0.621), and wearing-off (p = 0.220).

Conclusion: This study found that depression of drug-naïve, early-stage PD patients is associated with the occurrence of postural instability and FOG, but not with levodopa-induced dyskinesia and wearing-off. This suggests shared non-dopaminergic pathogenic mechanisms, and potentially enables the prediction of the early development of axial motor symptoms.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/depression-and-progression-of-motor-symptoms-in-early-stage-of-parkinsons-disease/