Objective: To compare serum uric acid (sUA) levels in Parkinson’s disease (PD) subjects to cognitive function.

Background: Reduced sUA levels have been reported in individuals with PD and have been suggested as a risk factor for more rapid disease progression. [1-5] sUA is a natural antioxidant in blood and the brain. It can reduce brain damage caused by oxidative stress. [3,4] Studies have shown that more than half of the antioxidant capacities of humans are derived from sUA. Contrarily, high sUA concentrations have been associated with cognitive impairment and vascular dementia in older non-PD individuals. [5,6] This study sought to compare sUA levels to the Montreal Cognitive Assessment (MoCA) in individuals with PD.

Method: 46 individuals with PD (37 men, 69 y ± 7.7; 9 women 67.7 y ± 8.4) and 14 healthy non-PD (9 men 63y ± 9.3; 5 women 61.8 y ± 9.5) consented to this study conducted at the NYIT, Adele Smithers Parkinson’s Disease program in Old Westbury, NY. Subjects had non fasting sUA levels analyzed and completed the MoCA assessment with a health professional. The MoCA assesses cognitive impairment on a scale from zero-30, with a score of 26 or higher considered normal.

Results: sUA was analyzed as a continuous variable. T-tests were used to assess differences between groups for continuous variables and Fishers exact tests were used to measure differences in categorical variables. Alpha was set to 0.05. The mean sUA was 4.69 ± 1.26 in PD subjects and 5.80 ± 1.30 in controls and the difference was statistically significant (p=0.006). When 12 PD cases with a normal cognitive score (>26) were compared to controls, the difference in sUA was no longer significant (5.22 ± 0.97, controls 5.80 ± 1.30; p=0.21). However, 34 PD cases with abnormal cognitive ability (< 26), the difference in sUA was significantly different (4.51, ± 1.31; controls 5.80 ± 1.30; p=0.003).

Conclusion: sUA levels were significantly lower in the PD subjects that demonstrated cognitive decline on the MoCA test compared to controls, whereas PD subjects who demonstrated no cognitive decline had similar sUA levels as controls. These results support previous research indicating lower sUA levels in PD subjects, but are contradictive to what has been demonstrated in non-PD individuals with cognitive decline. Further research is needed to understand whether lower sUA causes cognitive decline in PD.

References: [1] Shen L, Ji HF. Low uric acid levels in patients with Parkinson’s disease: evidence from meta-analysis. BMJ Open. 2013;3(11):e003620. (http://dx.doi.org/10.1136/+bmjopen-2013-003620) [2] Sakuta H, Suzuki K, Miyamoto T, et al. Serum uric acid levels in Parkinson’s disease and related disorders. Brain Behav. 2017;7(1):e00598. doi: 10.1002/brb3.598 [3] Yu Z, Zhang S, Wang D, et al. The significance of uric acid in the diagnosis and treatment of Parkinson disease: An updated systemic review. Medicine (Baltimore). 2017;96(45):e8502. doi: 10.1097/MD.0000000000008502 [4] Beydoun MA, Canas JA, Dore GA, et al. Serum Uric Acid and Its Association with Longitudinal Cognitive Change Among Urban Adults. J Alzheimers Dis. 2016;52(4):1415-30. doi:+10.3233/JAD-160028 [5] Zhong LL, Song YQ, Tian XY, Cao H, Ju KJ. Level of uric acid and uric acid/creatinine ratios in correlation with stage of Parkinson disease. Medicine (Baltimore). 2018;97(26):e10967. doi: 10.1097/MD.0000000000010967 [6] Tana C, Ticinesi A, Prati B, Nouvenne A, Meschi T. Uric Acid and Cognitive Function in Older Individuals. Nutrients. 2018;10(8) doi: 10.3390/nu10080975

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MDS Abstracts - https://www.mdsabstracts.org/abstract/serum-uric-acid-levels-and-cognitive-function-in-parkinsons-disease/