title: Nonmotor and diagnostic findings in subjects with de novo Parkinson disease of the DeNoPa cohort.
abstract: OBJECTIVE
  To determine nonmotor signs (NMS) and evaluate the utility of several diagnostic tools in patients with de novo Parkinson disease (PD).
  
  
  METHODS
  This is a large single-center study of the DeNoPa cohort, including frequency-matched healthy controls. This study covers motor signs, NMS, and a combination of diagnostic tests including olfactory testing, transcranial sonography of substantia nigra (TCS), and polysomnography (PSG). We report the frequency and characteristics of NMS and the outcomes of nonmotor tests at the time of diagnosis.
  
  
  RESULTS
  Cross-sectional analyses of baseline investigations identified significant differences in the NMS Questionnaire (NMSQuest) and the Scopa-AUT Gastrointestinal score in 159 drug-naïve PD patients vs 110 controls. In addition, patients with PD showed reduced olfactory function, hyperechogenicity on TCS, and higher frequency of REM sleep behavior disorder (RBD). In exploring predictive markers, we found that the combination of several investigations, i.e., the NMSQuest, Scopa-AUT Gastrointestinal score, and Smell Identification Test reached an area under the receiver operating characteristic curve (AUC) of 0.913 (95% confidence interval [CI] 0.878-0.948). With the addition of serum cholesterol and mean heart rate values, the AUC value reached 0.919 (95% CI 886-0.953); when TCS and PSG were added, the AUC increased to 0.963 (95% CI 0.943-0.982).
  
  
  CONCLUSIONS
  We show feasibility and utility of standardized data acquisition in a large, single-center cohort of patients with de novo PD and matched healthy controls. The baseline results from our prospective investigations reached a value of >0.9 sensitivity and specificity for biological markers when we added routine laboratory investigations and quantified nonmotor features including sleep.
authors.affiliation: From the Center of Parkinsonism and Movement Disorders (B.M., E.T., F.S.-D., T.W., J.E., M.S., E.L., C.T.), Paracelsus-Elena-Klinik, Kassel; Department of Neurosurgery (B.M., N.K.F., C.T.), University Medical Centre, Goettingen; Department of Psychology (E.T.), University Kassel; Section of Clinical and Molecular Neurogenetics at the Department of Neurology (K.R.K., K.L., C.K.), University of Luebeck; Departments of Neuropathology (B.M.) and Medical Statistics (T.F.), University Medical Centre, Goettingen, Germany; Program in Neuroscience (M.G.S.), Ottawa Hospital Research Institute; Division of Neurology, The Ottawa Hospital, University of Ottawa, Canada; and ReSearch Pharmaceutical Services (R.K.), Nuremberg, Germany.
authors.forename: Brit
authors.initials: B
authors.lastname: Mollenhauer
authors.forename: Ellen
authors.initials: E
authors.lastname: Trautmann
authors.forename: Friederike
authors.initials: F
authors.lastname: Sixel-Döring
authors.forename: Tamara
authors.initials: T
authors.lastname: Wicke
authors.forename: Jens
authors.initials: J
authors.lastname: Ebentheuer
authors.forename: Martina
authors.initials: M
authors.lastname: Schaumburg
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Lang
authors.forename: Niels K
authors.initials: NK
authors.lastname: Focke
authors.forename: Kishore R
authors.initials: KR
authors.lastname: Kumar
authors.forename: Katja
authors.initials: K
authors.lastname: Lohmann
authors.forename: Christine
authors.initials: C
authors.lastname: Klein
authors.forename: Michael G
authors.initials: MG
authors.lastname: Schlossmacher
authors.forename: Ralf
authors.initials: R
authors.lastname: Kohnen
authors.forename: Tim
authors.initials: T
authors.lastname: Friede
authors.forename: Claudia
authors.initials: C
authors.lastname: Trenkwalder
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D015415:Biomarkers; D003430:Cross-Sectional Studies; D004562:Electrocardiography; D005240:Feasibility Studies; D005260:Female; D005858:Germany; D006403:Hematologic Tests; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010300:Parkinson Disease / Q000175:diagnosis* / Q000235:genetics / Q000503:physiopathology; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires
chemical_list: D015415:Biomarkers