Objective: This study evaluates whether clinical, biological, and neuroimaging baseline markers can predict the onset of significant cognitive-based milestones developed in these cohorts over a 5-year period in individuals with idiopathic Parkinson’s disease (PD).

Background: Cognitive decline is a usual feature of PD that significantly impacts the patient’s quality of life. Predicting patients who will achieve relevant cognitive dysfunction could lead to a more tailored approach to treat PD patients.

Method: We analyzed data from the Parkinson’s Progression Markers Initiative (https://www.ppmi-info.org/access-data-specimens/download-data) to compare individuals with PD who developed a cognitive milestone  [1] [table 1].

We compared baseline sociodemographic data, magnetic resonance imaging (MRI) volumetric brain data using freesurferv7.4.1 recon-all pipeline, and CSF SAA. Comparisons were conducted using generalized linear models, adjusting for age, gender, and education. Baseline comparisons between groups were performed using t-tests and chi-squared tests. Data analysis was conducted employing Python version 3.6.

Results: We found that 48 patients reached the milestone at year five and 369 did not, table 2 provide a demographic view of those two groups [table 2].

About the relevant findings encountered in our analysis clinical features showed the biggest number followed by biomarkers and neuroimaging table 1.

In neuroimaging the anterior cingulate cortex was the only region with significant differences between the groups. In the biomarkers data only CSF SAA showed a relevant difference.

In the clinical features having a higher UPDRS and in its subdivisions (motor and non-motor) in baseline was associated with reaching the milestone in five years. Especially interesting was that gait and walk (from UPRS) showed by themselves significance in reaching the milestone.

Another peculiar finding our exploratory analysis showed was the alternation in baseline in the apathy sub division of UPDRS and alteration in geriatric depression scale, two symptoms historically associated with anterior cingulate córtex [table 3].

Conclusion: In conclusion, our initial exploratory analysis of the PPMI data set is trying to explore more possible markers of progression based on the cognitive milestone defined by experts trying to quantify important cognitive outcomes in PD.

Table 1. Cognitve milestones definition

Demographic data with standard deviation

Table 3. Statistical signifcant variables

References: 1. Brumm MC, Siderowf A, Simuni T, Burghardt E, Choi SH, Caspell-Garcia C, Chahine LM, Mollenhauer B, Foroud T, Galasko D, Merchant K, Arnedo V, Hutten SJ, O’Grady AN, Poston KL, Tanner CM, Weintraub D, Kieburtz K, Marek K, Coffey CS; Parkinson’s Progression Markers Initiative. Parkinson’s Progression Markers Initiative: A Milestone-Based Strategy to Monitor Parkinson’s Disease Progression. J Parkinsons Dis. 2023;13(6):899-916. doi: 10.3233/JPD-223433. PMID: 37458046; PMCID: PMC10578214.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/clinical-and-neuroimaging-biomarker-predictors-of-cognitive-dysfunction-in-parkinsons-disease-a-study-using-ppmi-data/