Objective: To create a pan-Indian clinical repository of Parkinson’s Disease (PD).

Background: The genetic risk for PD in India is unknown. The Luxembourg-German India Alliance on Neurodegeneration and Therapeutics (LUX-GIANT) is a trilateral consortium formed to fill this knowledge gap. The GAP-India (Genetic architecture of PD in India) study is a GWAS conducted by the consortium and is currently recruiting 10000 patients and 10000 controls over 2 years

Method: A multi-institutional network of movement disorder specialists and neurologists from 18 tertiary care centres across India recruited PD patients of Asian Indian origin who fulfilled the UKPD Brain Bank criteria. Controls were ethnicity-matched healthy subjects originating from the same geographical area and without a family history of PD. An interim analysis of the demographic and clinical data was performed at 1 year.

Results: Among the11,033 subjects, 4394 were cases (male 69%, mean age 60.3±11years) and 6639 controls (male 63.4%, mean age 41.6 ± 14.6 years). The mean age at onset of motor symptoms was 53.5 (11.5) years. The PD group was older (P<0.001) and had more comorbid diseases. A family history of PD was present in 10% of cases. Risk factors for PD based on crude odds ratio (P<0.001 in all comparisons) were older age (OR=1.1/year), male gender (OR=1.3), history of head injury (OR=5.3), agriculture as profession (OR= 2.9), pesticide exposure (OR=1.5) and comorbid diseases such as diabetes (OR=5.3), hypertension (OR=5.9), cancer (OR=4.3) and coronary artery disease (OR=10.1). The mean UPDRS III was 27.8 (17.6). 68% of patients were in Hoehn and Yahr stages 2 and 3. Cognitive (mean MOCA 23.8± 5.1) and depression scores (mean BDI=10.4±7.1) in cases were worse than in controls (P <0.001). Neuroimaging was performed in 75% of cases; MRI in 46%, CT in 17.4% and FD PET or TRODAT in 5%. Levodopa (90%) and dopamine agonist (66%) were used most frequently for treatment. Only 11% received DBS.

Conclusion: This is the largest description of a pan-Indian, cohort of PD recruited by movement disorder specialists and neurologists. The demographic profile reveals a striking feature of younger age of onset of motor symptoms in Indian PD when compared to reports from the West. The genetic and environmental risk factors and their interactions in Indian PD will be reported in future.

« Back to 2022 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/clinical-and-risk-profiles-of-parkinsons-disease-from-a-large-pan-india-cohort-interim-observations-of-the-gap-india-study/