Objective: to evaluate the impact of personality on non-motor fluctuations (NMFs) in Parkinson’s disease (PD) and on NMFs evolution after dopaminergic treatments or deep brain stimulation of the subthalamic nucleus (DBS-STN).

Background: NMFs is a disabling symptom that occurs in 17% to 100% of PD patients with motor fluctuations [1] and can present various forms (psychiatric, cognitive or dysautonomic fluctuations [2]). Currently, NMFs are associated with early onset of PD, longer disease-duration, higher doses of levodopa and female gender [2]. Nonetheless, their occurrence and evolution remain misunderstood. Our study aims to determine whether the development of NMFs and responses to treatment can be predicted by bio-psycho-social factors such as personality dimensions.

Method: PD patients (n=214) were enrolled from the PREDI-STIM cohort (NCT02360683). Personality dimensions (Temperament and Character Inventory (TCI)) [3] was assessed at baseline (V0) and NMFs (NMFs Severity Scale (NMF2S)) [4] were evaluated at V0 in ON and OFF medication conditions and after one year of DBS-STN (V1) in OFF medication-OFF stimulation (OFF-OFF) and OFF medication-ON stimulation (OFF-ON) conditions. Spearman correlations were done between each personality dimensions of the TCI and NMFs scores at V0, percentages of NMFs changes between ON and OFF at V0, and percentages of NMFs changes between OFF-OFF and OFF-ON at V1.

Results: At V0, NMFs scores were significantly correlated with Harm Avoidance temperament (positive) and Self-Directedness character (negative) scores, while Novelty Seeking temperament scores were significantly and positively correlated with NMFs changes at V1. TCI dimensions did not correlate with NMFs dopa-sensitivity.

Conclusion: PD patients with a high degree of Harm Avoidance and a low degree of Self-Directedness had the most severe NMFs at baseline. Hence, some personality dimensions may predispose PD patients to develop NMFs. Personality dimensions did not correlate with NMFs dopa-sensitivity but Novelty Seeking temperament was associated with NMFs changes following DBS-STN. Therefore, PD patients with high Novelty Seeking may be better responders for NMFs improvement by DBS. These results could therefore be used in clinical practice in the context of personalized medicine.

References: [1] Witjas T, Kaphan E, Azulay JP. Les fluctuations non motrices de la maladie de Parkinson. Rev Neurol (Paris). 1 sept 2007;163(8):846‑50.
[2] Martínez-Fernández R, Schmitt E, Martinez-Martin P, Krack P. The hidden sister of motor fluctuations in Parkinson’s disease: A review on nonmotor fluctuations. Mov Disord. 2016;31(8):1080‑94.
[3] Cloninger CR, Przybeck TR, Svrakic DM, Wetzel RD. The temperament and character inventory (TCI): a guide to its development and use. St. Louis, Mo.: Center for Psychobiology of Personality, Washington University; 1994.
[4] Faggianelli F, Witjas T, Azulay JP, Benatru I, Hubsch C, Anheim M, et al. ON/OFF non-motor evaluation: a new way to evaluate non-motor fluctuations in Parkinson’s disease. J Neurol Neurosurg Psychiatry. 25 janv 2024;jnnp-2023.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/personality-of-parkinsons-disease-patients-may-influence-the-development-and-evolution-of-non-motor-fluctuations/