title: Combined dementia-risk biomarkers in Parkinson's disease: a prospective longitudinal study.
abstract: Neuropsychological (mostly posterior-cortical) deficits, quantitative magnetic resonance imaging (MRI) atrophy patterns, and low cerebrospinal fluid (CSF) levels of amyloid-β have been separately related to worsening cognition in Parkinson's disease (PD). However, these biomarkers have not been longitudinally assessed in combination as PD-dementia predictors. In this prospective longitudinal study, 27 non-demented PD patients underwent CSF, neuropsychological and 3-T brain-MRI studies at baseline and were re-assessed 18 months later in terms of progression to dementia (primary outcome) and longitudinal neuropsychological and cortical thickness changes (secondary outcomes). At follow-up 11 patients (41%) had progressed to dementia. Lower CSF amyloid-β, worse verbal learning, semantic fluency and visuoperceptual scores, and thinner superior-frontal/anterior cingulate and precentral regions were significant baseline dementia predictors in binary logistic regressions as quantitative and/or dichotomised traits. All participants without baseline biomarker abnormalities remained non-demented whereas all with abnormalities in each biomarker type progressed to dementia, with intermediate risk for those showing abnormalities in a single to two biomarker types (p = 0.006). Both the dementia-outcome and low baseline CSF amyloid-β were prospectively associated with limbic and posterior-cortical neuropsychological decline and frontal, limbic and posterior-cortical thinning from baseline to follow-up. These findings suggest that the combination of CSF amyloid-β, neuropsychological and cortical thickness biomarkers might provide a basis for dementia-risk stratification and progression monitoring in PD.
authors: Parkinson Disease and Movement Disorders Unit, Neurology Service, IDIBAPS, CIBERNED, Hospital Clínic, Barcelona, Catalonia, Spain.
authors: Yaroslau
authors: Y
authors: Compta
authors: Joana B
authors: JB
authors: Pereira
authors: Jose
authors: J
authors: Ríos
authors: Naroa
authors: N
authors: Ibarretxe-Bilbao
authors: Carme
authors: C
authors: Junqué
authors: Núria
authors: N
authors: Bargalló
authors: Ana
authors: A
authors: Cámara
authors: Mariateresa
authors: M
authors: Buongiorno
authors: Manel
authors: M
authors: Fernández
authors: Claustre
authors: C
authors: Pont-Sunyer
authors: Maria J
authors: MJ
authors: Martí
mesh_terms: D000368:Aged; D016229:Amyloid beta-Peptides / Q000134:cerebrospinal fluid*; D015415:Biomarkers / Q000134:cerebrospinal fluid; D003430:Cross-Sectional Studies; D003704:Dementia / Q000134:cerebrospinal fluid* / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000134:cerebrospinal fluid* / Q000175:diagnosis* / Q000453:epidemiology; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D016229:Amyloid beta-Peptides; D015415:Biomarkers