Non-motor symptoms in patients with Parkinson's disease - correlations with inflammatory cytokines in serum.
BACKGROUND
Parkinson's Disease (PD) is the second most common neurodegenerative disorder of the central nervous system. Motor symptoms are the focus of pharmacotherapy, yet non-motor features of the disease (e.g. fatigue, mood disturbances, sleep disturbances and symptoms of anxiety) are both common and disabling for the patient. The pathophysiological mechanisms behind the non-motor symptoms in PD are yet to be untangled. The main objective of this study was to investigate associations between pro-inflammatory substances and non-motor symptoms in patients with PD.


METHODS
We measured C-reactive protein, interleukin (IL)-6, soluble IL-2 receptor (sIL-2R) and tumor necrosis factor-α (TNF-α) in blood samples from PD patients (n=86) and healthy controls (n=40). Symptoms of fatigue, depression, anxiety and sleeping difficulties were assessed using the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT), the Hospital Anxiety and Depression Scale (HAD), and the Scales for Outcome in PD-Sleep Scale respectively.


RESULTS
IL-6 was significantly higher in PD patients than in healthy controls. Compared to healthy controls, PD patients displayed significantly higher mean scores on HAD and lower scores on FACIT, thus indicating more severe symptoms as measured with these scales. Within the PD sample, high levels of both sIL-2R and TNF-α were significantly associated with more severe symptoms assessed by means of FACIT and HAD (depression and anxiety subscales). SIL-2-R levels were able to significantly predict FACIT and HAD scores after the effects of age, gender, anti-parkinsonian medications, and severity of motor symptoms were controlled for.


CONCLUSIONS
We suggest that non-motor symptoms in PD patients, such as fatigue and depressive symptoms, might be generated via inflammatory mechanisms. This knowledge might contribute to the development of novel treatment options in PD, specifically targeting non-motor symptoms.
Department of Clinical Sciences, Section for Psychiatry, Lund University, Lund, Sweden. Daniel.Lindqvist@med.lu.se
Daniel
D
Lindqvist
Eli
E
Kaufman
Lena
L
Brundin
Sara
S
Hall
Yulia
Y
Surova
Oskar
O
Hansson
D002097:C-Reactive Protein; D016022:Case-Control Studies; D015986:Confounding Factors, Epidemiologic; D016207:Cytokines / Q000097:blood*; D005260:Female; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood*; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D010300:Parkinson Disease / Q000097:blood* / Q000503:physiopathology*; D015375:Receptors, Interleukin-2 / Q000097:blood; D012044:Regression Analysis; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
D016207:Cytokines; D018836:Inflammation Mediators; D015850:Interleukin-6; D015375:Receptors, Interleukin-2; D014409:Tumor Necrosis Factor-alpha; D002097:C-Reactive Protein