Objective: To examine longitudinal change in excessive daytime sleepiness (EDS) in the cohort of at baseline de novo Parkinson’s disease (PD) subjects.

Background: We have previously reported prevalence and clinico biological correlates of EDS in the cohort of at baseline de novo PD subjects compared to the matched healthy controls (HC). We now report longitudinal data on the evolution of EDS in that cohort.

Methods: Parkinson’s Progression Markers Initiative (PPMI) is a longitudinal on-going case-control study of de novo, untreated PD participants at enrolment. Participants contribute a wide range of motor and non-motor measures, including biofluids and imaging biomarkers. EDS was defined as Epworth sleepiness scale (ESS) score ≥10.

Results: There were 423 PD subjects and 196 age and gender matched HC at baseline. Longitudinal data at the time of analysis were available for 397 PD subjects at one year, 378 at 2 years and 204 at 3 years. The mean (SD) EDS score changed from 5.8 (3.5) to 7.6 (4.60) (p<0.0001) in PD subjects vs NS change in HC. At baseline 16% PD vs 12.3% HC subjects had EDS (p= 0.28). At 3 years prevalence of EDS was 27% in PD vs 16.5% in HC (p=0,026). At every time point EDS was significantly associated with MDS-UPDRS total score, Part I and II but not with Part III motor score, higher depression (GDS), autonomic dysfunction (SCOPA-COG), anxiety (STAI) and REM sleep behavior scores but not with cognition (MOCA) score. PD medications effect measured in levodopa equivalence (LED) became significant only at 3 year point (p=0.0005). None of the biofluids markers were associated with the EDS at one year, further longitudinal biofluids data are not yet available. EDS was associated with reduced DAT tracer uptake at year 1 and 2 (scans are not performed at year 3).

Conclusions: There is significant increase in the prevalence of EDS in early PD over time versus no significant change in HC. Longitudinally EDS is associated with the same clinical variables as at the baseline. Based on this preliminary analysis PD medications effect on EDS is dose dependent. Future analysis will establish association of EDS with changes in the imaging and biomarkers.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/longitudinal-evolution-of-excessive-daytime-sleepiness-in-early-parkinsons-disease/