Objective: To determine how motor features emerge over time in individuals estimated to be at higher risk of Parkinson’s disease (PD), compared with lower risk participants in the PREDICT-PD study.

Background: PREDICT-PD is a web-based cohort study which aims to identify individuals aged 60-80 at risk of future PD from the UK general population¹. After enrolment in the pilot phase of the study in 2012, individuals that were classified as higher risk (HR) or lower risk (LR) (highest and lowest 15% of risks scores) were reviewed ‘in person’. Participants in the HR group were more likely to have subtle motor impairment compared with LR participants².

Method: HR and LR participants were re-examined using the motor section of Unified PD Rating Scale (MDS-UPDRS-III) after a minimum of 5-year follow-up. All assessments were carried out between 2018 and 2019.

Results: We reviewed 132 participants (HR:33, LR:99) after mean duration of 5.8 years (SD 0.98). HR participants were predominantly male (74.2% vs 44.4%) and older than LR participants (77.2 years vs 73.6 years, p<0.001).
A greater change in MDS-UPDRS-III was observed amongst HR participants compared to LR group (36% vs 13% increasing > 5 points in the motor scale, p=0.025). Seven participants (HR: 4 (12%); LR: 3 (3%)) had clinical features suggestive of PD on examination. In these participants, the median MDS-UPDRS-III at baseline was 8.3 (IQR: 3-14) and at follow-up it was 18.4 (IQR: 12-25). Separately, two participants in the HR group had already been given a diagnosis of PD during follow-up with motor signs demonstrated 2 and 5 years before fulfilling clinical diagnostic criteria.

Conclusion: This study helps identify early motor features and their evolution during pre-diagnostic phase of PD.

References: (1) Noyce, A. J., Bestwick, J. P., Silveira-Moriyama, L., Hawkes, C. H., Knowles, C. H., Hardy, J., … & Schrag, A. (2014). PREDICT-PD: Identifying risk of Parkinson’s disease in the community: methods and baseline results. J Neurol Neurosurg Psychiatry, 85(1), 31-37. (2) Noyce, A. J., Schrag, A., Masters, J. M., Bestwick, J. P., Giovannoni, G., & Lees, A. J. (2017). Subtle motor disturbances in PREDICT-PD participants. Journal of Neurology, Neurosurgery & Psychiatry, 88(3), 212-217.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/emerging-parkinsonism-in-the-predict-pd-cohort-after-6-years-of-follow-up/