Rapid eye movement sleep behavior disorder (RBD), excessive daytime sleepiness (EDS), and greater autonomic symptom burden are associated with greater risk of future psychotic symptoms in Parkinson disease (PD), according to a recent study. Furthermore, reduced cholinergic nucleus 4 (Ch4) density at baseline is associated with future psychotic symptoms and a greater burden of RBD, EDS, and autonomic symptoms. This cohort study evaluated 423 patients with newly diagnosed PD collected as part of the Parkinson's Progression Markers Initiative. Psychotic symptoms were assessed with the Movement Disorders Society–Unified Parkinson Disease Rating Scale item 1.2, which assesses hallucinations and psychosis over the past week. Researchers found:
- Multivariate logistic regression adjusted for age and sex found that greater autonomic symptoms, RBD, and EDS at baseline were associated with increased risk of reporting psychotic symptoms on ≥2 occasions.
- Having 2 or 3 of these baseline symptoms was associated with lower Ch4 density.
- In a logistic regression model adjusted for age and sex, higher Ch4 gray matter density was associated with lower risk of reporting psychotic symptoms on ≥2 occasions.
Barrett MJ, Blair JC, Sperling SA, Smolkin ME, Druzgal TJ. Baseline symptoms and basal forebrain volume predict future psychosis in early Parkinson disease. Neurology. 2018;90(18): e1618-e1626. doi:10.1212/WNL.0000000000005421.
This Week's Must Reads
Recurrent Stroke Risk Higher for Blacks than Whites, Neurology; ePub 2018 Oct 3; Albright, Huang, et al
Sleep Duration/Stroke Link Differs by Race and Sex, Neurology; ePub 2018 Oct 3; Petrov, Howard, et al
Intracerebral Hemorrhage Survivors’ Outcomes Studied, J Stroke Cerebrovasc Dis; ePub 2018 Sep 28; Griauzde, et al
Probable OSA Common in Refractory Epilepsy, Epilepsia; ePub 2018 Sep 24; McCarter, et al
FDA Approves Tiglutik for Treatment of ALS, ITF Pharma news release; 2018 Sep 6
Must Reads in Movement Disorders
Is RLS Associated with Premotor Symptoms of PD?, J Neurol Sci; ePub 2018 Sep 1; Iwaki, Hughes, et al
Cognition Function and Increased Risk for PD, PLoS One; ePub 2018 Aug 20; Chahine, et al
Comparison of Tests for Cognitive Deficits in PD, Mov Disord; ePub 2018 Sep 14; Hoogland, et al
Spiral Drawings in ET Measure Motor Learning, Cerebellum; ePub 2018 Sep 11; Kim, Luo, et al
Appendectomy and Risk of Parkinson Disease, Mov Disord; ePub 2018 Sep 14; Palacios, et al