title: Plasma EGF and cognitive decline in Parkinson's disease and Alzheimer's disease.
abstract: Cognitive decline occurs in multiple neurodegenerative diseases, including Alzheimer's disease (AD) and Parkinson's disease (PD). Shared underlying mechanisms may exist and manifest as shared biomarker signatures. Previously, we nominated plasma epidermal growth factor (EGF) as a biomarker predicting cognitive decline in patients with established PD. Here, we investigate EGF as a predictive biomarker in prodromal PD, as well as AD.
  
  
  
  A cohort of PD patients (n = 236) was recruited to replicate our finding that low baseline EGF levels predict future cognitive decline. Additionally, plasma EGF and cognitive outcome measures were obtained from individuals with normal cognition (NC, n = 58), amnestic mild cognitive impairment (AD-MCI, n = 396), and Alzheimer's disease (AD, n = 112) in the Alzheimer's Disease Neuroimaging Initiative (ADNI) cohort to investigate whether low EGF levels correlate with cognitive status and outcome in AD-MCI and AD. Third, plasma EGF and cognitive measures were evaluated in the high-risk asymptomatic Parkinson's Associated Risk Study (PARS) cohort (n = 165) to investigate the association of EGF and cognitive performance in a PD prodromal context.
  
  
  
  In both PD and AD-MCI, low baseline plasma EGF predicted poorer long-term cognitive outcomes. In asymptomatic individuals at highest risk for developing PD from the PARS cohort, low baseline plasma EGF associated with poorer performance in the visuospatial domain but not in other cognitive domains.
  
  
  
  Low plasma EGF at baseline predicts cognitive decline in both AD and PD. Evidence for this signal may exist in prodromal stages of both diseases.
authors.affiliation: Department of Neurology Perelman School of Medicine at the University of Pennsylvania Philadelphia Pennsylvania.
authors.forename: Nicholas S
authors.initials: NS
authors.lastname: Lim
authors.affiliation: Department of Neurology Perelman School of Medicine at the University of Pennsylvania Philadelphia Pennsylvania.
authors.forename: Christine R
authors.initials: CR
authors.lastname: Swanson
authors.affiliation: Department of Neurology Perelman School of Medicine at the University of Pennsylvania Philadelphia Pennsylvania.
authors.forename: Hua-Ren
authors.initials: HR
authors.lastname: Cherng
authors.affiliation: Department of Neurology Perelman School of Medicine at the University of Pennsylvania Philadelphia Pennsylvania.
authors.forename: Travis L
authors.initials: TL
authors.lastname: Unger
authors.affiliation: Department of Biostatistics and Epidemiology Perelman School of Medicine at the University of Pennsylvania Philadelphia Pennsylvania.
authors.forename: Sharon X
authors.initials: SX
authors.lastname: Xie
authors.affiliation: Department of Psychiatry Perelman School of Medicine at the University of Pennsylvania Philadelphia Pennsylvania.
authors.forename: Daniel
authors.initials: D
authors.lastname: Weintraub
authors.affiliation: Parkinson's Associated Risk Study New Haven, CT USA; Institute for Neurodegenerative Disorders New Haven Connecticut.
authors.forename: Ken
authors.initials: K
authors.lastname: Marek
authors.affiliation: Department of Neurology Perelman School of Medicine at the University of Pennsylvania Philadelphia Pennsylvania; Parkinson's Associated Risk Study New Haven, CT USA.
authors.forename: Matthew B
authors.initials: MB
authors.lastname: Stern
authors.affiliation: Avid Radiopharmaceuticals Philadelphia Pennsylvania.
authors.forename: Andrew
authors.initials: A
authors.lastname: Siderowf
authors.affiliation: Department of Pathology and Laboratory Medicine Perelman School of Medicine at the University of Pennsylvania Philadelphia Pennsylvania.
authors.forename: John Q
authors.initials: JQ
authors.lastname: Trojanowski
authors.affiliation: Department of Neurology Perelman School of Medicine at the University of Pennsylvania Philadelphia Pennsylvania.
authors.forename: Alice S
authors.initials: AS
authors.lastname: Chen-Plotkin
keywords: Alzheimer's disease; EGF; Parkinson's disease; biomarker; cognition; epidermal growth factor; plasma