Objective: to evaluate the impact of personality on quality-of-life (QoL) amelioration after treatment by Continuous Subcutaneous Apomorphine Infusion (CSAI) in Parkinson’s disease (PD).

Background: PD patients severely affected by motor fluctuations need second-line treatments such as Deep Brain Stimulation (DBS) or CSAI. Currently there is a lack of predictive factors that would allow PD patients to be optimally oriented towards DBS or CSAI [1]. Our previous study showed that certain personality dimensions were associated with QoL amelioration after one year of DBS [2], but the influence of personality dimensions on improved QoL after CSAI has yet to be studied.

Method: PD patients waiting for CSAI were enrolled (n=35) in the PSYCHO-PERF study (NCT03793491). Personality dimensions (Temperament and Character Inventory (TCI)) [3] was assessed at baseline (V0) and QoL (Parkinson’s disease questionnaire 39 (PDQ-39)) was evaluated at V0 and after six months of CSAI (V1). Linear regression models were done between each TCI dimensions and i) PDQ-39 scores at V0 and ii) percentages of PDQ-39 changes at V1.

Results: Higher Reward Dependence scores were associated with a better QoL outcome after six months of CSAI while Self-Directedness scores were associated with a better QoL before CSAI (as opposed to Harm Avoidance, Reward Dependence and Self-Transcendence scores associated with a worst QoL before CSAI).

Conclusion: Personality dimensions could be predictive of a better QoL amelioration after second-line treatments. PD patients with higher Reward Dependence scores (highly emotional, sensitive and affective individuals in need of social support) at baseline had the best QoL improvement after six months of CSAI. This finding could be used to better prepare and accompany patients during CSAI establishment. Moreover, this result could serve as an orientation factor to second-line treatments.

References: [1] Martinez-Martin P, Reddy P, Katzenschlager R, Antonini A, Todorova A, Odin P, et al. EuroInf: A Multicenter Comparative Observational Study of Apomorphine and Levodopa Infusion in Parkinson’s Disease. Mov Disord. 2015;30(4):510‑6.
[2] Boussac M, Arbus C, Dupouy J, Harroch E, Rousseau V, Ory-Magne F, et al. Personality Dimensions Are Associated with Quality of Life in Fluctuating Parkinson’s Disease Patients (PSYCHO-STIM). J Park Dis. 1 janv 2020;10(3):1057‑66.
[3] Cloninger CR, Przybeck TR, Svrakic DM, Wetzel RD. The temperament and character inventory (TCI): a guide to its development and use. St. Louis, Mo.: Center for Psychobiology of Personality, Washington University; 1994.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/personality-may-influence-the-response-to-apomorphine-infusion-in-parkinsons-disease-patients/