Objective: To determine whether the personality changes demonstrated in established Parkinson’s disease (PD) are found in the earliest stages of PD and the prodromal stage.

Background: Individuals with established PD tend to be risk averse and have less novelty seeking behaviours. However, little is known about the earliest and prodromal stages. Careful delineation of the personality profile associated with early PD, and its relationship with addictive behaviours, can help answer important questions about the mechanisms underlying PD and addiction.

Methods: 864 population-ascertained PD subjects within 3.5 years of diagnosis, 90 patients with rapid eye movement sleep behaviour disorder (RBD) and 294 control subjects were fully characterised for motor symptoms, non-motor symptoms and across the following 5 personality domains: 1) neuroticism 2) extraversion 3) conscientiousness 4) agreeableness 5) openness using the Big Five Inventory.

Results: Patients with early PD were more neurotic (OR 2.7, p<0.001), less extraverted (OR 0.52, p<0.001) and less open than controls (OR 0.54, p<0.001). RBD subjects showed the same pattern of being more neurotic (OR 4.01, p<0.001), less exatraverted (OR 0.58, p=0.01) and less open (OR 0.42, p<0.001). PD patients were pre-morbidly less likely to smoke or drink alcohol than controls, but caffeine consumption was similar. RBD patients were more likely to ever have smoked than controls (OR 1.68, p=0.03). Being more extraverted (OR 2.03, p<0.001), more open (OR 2.50, p<0.001), more conscientious (OR 2.13, p=0.02) and less neurotic (OR 2.54, p<0.001) predicted higher alcohol use, while being less agreeable was associated with more smoking (OR 0.27, p=0.001).

Conclusions: The personality profile of a patient with PD differs from controls, even at the earliest stages. A similar personality profile is found in individuals with RBD, potentially due to a prodromal manifestation of PD. Personality traits do not explain the inverse association of smoking with PD.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/personality-and-addictive-behaviours-in-prodromal-and-early-parkinsons-disease/