title: Higher Plasma LDL-Cholesterol is Associated with Preserved Executive and Fine Motor Functions in Parkinson's Disease.
abstract: Plasma low density lipoprotein (LDL) cholesterol has been associated both with risk of Parkinson's disease (PD) and with age-related changes in cognitive function. This prospective study examined the relationship between baseline plasma LDL-cholesterol and cognitive changes in PD and matched Controls. Fasting plasma LDL-cholesterol levels were obtained at baseline from 64 non-demented PD subjects (62.7 ± 7.9 y) and 64 Controls (61.3 ± 6.8 y). Subjects underwent comprehensive neuropsychological testing at baseline, 18-, and 36-months. Linear mixed-effects modeling was used to assess the relationships between baseline LDL-cholesterol levels and longitudinal cognitive changes. At baseline, PD patients had lower scores of fine motor (p<0.0001), executive set shifting (p=0.018), and mental processing speed (p=0.049) compared to Controls. Longitudinally, Controls demonstrated improved fine motor and memory test scores (p=0.044, and p=0.003), whereas PD patients demonstrated significantly accelerated loss in fine motor skill (p=0.002) compared to Controls. Within the PD group, however, higher LDL-cholesterol levels were associated with improved executive set shifting (β=0.003, p<0.001) and fine motor scores (β=0.002, p=0.030) over time. These associations were absent in Controls (p>0.7). The cholesterol - executive set shifting association differed significantly between PDs and Controls (interaction p=0.005), whereas the cholesterol - fine motor association difference did not reach significance (interaction, p=0.104). In summary, higher plasma LDL-cholesterol levels were associated with better executive function and fine motor performance over time in PD, both of which may reflect an effect on nigrostriatal mediation. Confirmation of these results and elucidation of involved mechanisms are warranted, and might lead to feasible therapeutic strategies.
authors.affiliation: 1Departments of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033, USA.
authors.forename: Nicholas W
authors.initials: NW
authors.lastname: Sterling
authors.affiliation: 1Departments of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033, USA.
authors.forename: Maya
authors.initials: M
authors.lastname: Lichtenstein
authors.affiliation: 1Departments of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033, USA.
authors.forename: Eun-Young
authors.initials: EY
authors.lastname: Lee
authors.affiliation: 1Departments of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033, USA.; 3Pharmacology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033, USA.
authors.forename: Mechelle M
authors.initials: MM
authors.lastname: Lewis
authors.affiliation: 1Departments of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033, USA.
authors.forename: Alicia
authors.initials: A
authors.lastname: Evans
authors.affiliation: 1Departments of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033, USA.; 2Public Health Sciences, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033, USA.; 4Radiology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033, USA.
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Eslinger
authors.affiliation: 1Departments of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033, USA.
authors.forename: Guangwei
authors.initials: G
authors.lastname: Du
authors.affiliation: 7Department of Nutritional Sciences, the Pennsylvania State University, University Park, PA 16802, USA.
authors.forename: Xiang
authors.initials: X
authors.lastname: Gao
authors.affiliation: 8Epidemiology Branch/Aging & Neuroepidemiology Group, National Institute of Environmental Health Sciences, Research Triangle Park, NC 27709, USA.
authors.forename: Honglei
authors.initials: H
authors.lastname: Chen
authors.affiliation: 2Public Health Sciences, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033, USA.
authors.forename: Lan
authors.initials: L
authors.lastname: Kong
authors.affiliation: 1Departments of Neurology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033, USA.; 3Pharmacology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033, USA.; 4Radiology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033, USA.; 5Neurosurgery, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033, USA.; 6Kinesiology, Pennsylvania State University-Milton S. Hershey Medical Center, Hershey PA 17033, USA.
authors.forename: Xuemei
authors.initials: X
authors.lastname: Huang
keywords: Parkinson’s disease; cholesterol; cognition; executive function; low density lipoprotein cholesterol (LDL-cholesterol); neuroprotection