The effect of cardiovascular risk on disease progression in de novo Parkinson's disease patients: An observational analysis
BackgroundCurrently available treatment options for Parkinson's disease are symptomatic and do not alter the course of the disease. Recent studies have raised the possibility that cardiovascular risk management may slow the progression of the disease.ObjectivesWe estimated the effect of baselin...
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Frontiers Media S.A.
2023-04-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2023.1138546/full |
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| author | Max J. Oosterwegel Max J. Oosterwegel Jesse H. Krijthe Melina G. H. E. den Brok Melina G. H. E. den Brok Lieneke van den Heuvel Edo Richard Edo Richard Tom Heskes Bastiaan R. Bloem Luc J. W. Evers Luc J. W. Evers |
| author_facet | Max J. Oosterwegel Max J. Oosterwegel Jesse H. Krijthe Melina G. H. E. den Brok Melina G. H. E. den Brok Lieneke van den Heuvel Edo Richard Edo Richard Tom Heskes Bastiaan R. Bloem Luc J. W. Evers Luc J. W. Evers |
| author_sort | Max J. Oosterwegel |
| collection | DOAJ |
| description | BackgroundCurrently available treatment options for Parkinson's disease are symptomatic and do not alter the course of the disease. Recent studies have raised the possibility that cardiovascular risk management may slow the progression of the disease.ObjectivesWe estimated the effect of baseline cardiovascular risk factors on the progression of Parkinson's disease, using measures for PD-specific motor signs and cognitive functions.MethodsWe used data from 424 de novo Parkinson's disease patients and 199 age-matched controls from the observational, multicenter Parkinson's Progression Markers Initiative (PPMI) study, which included follow-up of up to 9 years. The primary outcome was the severity of PD-specific motor signs, assessed with the MDS-UPDRS part III in the “OFF”-state. The secondary outcome was cognitive function, measured with the Montreal Cognitive Assessment, Symbol Digit Modalities Test, and Letter-Number Sequencing task. Exposures of interest were diabetes mellitus, hypertension, body mass index, cardiovascular event history and hypercholesterolemia, and a modified Framingham risk score, measured at baseline. The effect of each of these exposures on disease progression was modeled using linear mixed models, including adjustment for identified confounders. A secondary analysis on the Tracking Parkinson's cohort including 1,841 patients was performed to validate our findings in an independent patient cohort.ResultsMean age was 61.4 years, and the average follow-up was 5.5 years. We found no statistically significant effect of any individual cardiovascular risk factor on the MDS-UPDRS part III progression (all 95% confidence intervals (CIs) included zero), with one exception: in the PD group, the estimated effect of a one-point increase in body mass index was 0.059 points on the MDS-UPDRS part III per year (95% CI: 0.017 to 0.102). We found no evidence for an effect of any of the exposures on the rate of change in cognitive functioning in the PD group. Similar results were observed for the Tracking Parkinson's cohort (all 95% CIs overlapped with PPMI), but the 95% CI of the effect of body mass index on the MDS-UPDRS part III progression included zero.ConclusionsBased on this analysis of two large cohorts of de novo PD patients, we found no evidence to support clinically relevant effects of cardiovascular risk factors on the clinical progression of Parkinson's disease. |
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| language | English |
| last_indexed | 2024-04-09T18:23:57Z |
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| spelling | doaj.art-165cef11bcb54f09a7aba874f57068fc2023-04-12T05:16:26ZengFrontiers Media S.A.Frontiers in Neurology1664-22952023-04-011410.3389/fneur.2023.11385461138546The effect of cardiovascular risk on disease progression in de novo Parkinson's disease patients: An observational analysisMax J. Oosterwegel0Max J. Oosterwegel1Jesse H. Krijthe2Melina G. H. E. den Brok3Melina G. H. E. den Brok4Lieneke van den Heuvel5Edo Richard6Edo Richard7Tom Heskes8Bastiaan R. Bloem9Luc J. W. Evers10Luc J. W. Evers11Center of Expertise for Parkinson and Movement Disorders, Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, NetherlandsDepartment of Data Science, Institute for Computing and Information Sciences, Radboud University, Nijmegen, NetherlandsDepartment of Intelligent Systems, Delft University of Technology, Delft, NetherlandsDepartment of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, NetherlandsDepartment of Neurology, Amsterdam University Medical Center, Location AMC, Amsterdam, NetherlandsCenter of Expertise for Parkinson and Movement Disorders, Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, NetherlandsDepartment of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, NetherlandsDepartment of Neurology, Amsterdam University Medical Center, Location AMC, Amsterdam, NetherlandsDepartment of Data Science, Institute for Computing and Information Sciences, Radboud University, Nijmegen, NetherlandsCenter of Expertise for Parkinson and Movement Disorders, Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, NetherlandsCenter of Expertise for Parkinson and Movement Disorders, Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, NetherlandsDepartment of Data Science, Institute for Computing and Information Sciences, Radboud University, Nijmegen, NetherlandsBackgroundCurrently available treatment options for Parkinson's disease are symptomatic and do not alter the course of the disease. Recent studies have raised the possibility that cardiovascular risk management may slow the progression of the disease.ObjectivesWe estimated the effect of baseline cardiovascular risk factors on the progression of Parkinson's disease, using measures for PD-specific motor signs and cognitive functions.MethodsWe used data from 424 de novo Parkinson's disease patients and 199 age-matched controls from the observational, multicenter Parkinson's Progression Markers Initiative (PPMI) study, which included follow-up of up to 9 years. The primary outcome was the severity of PD-specific motor signs, assessed with the MDS-UPDRS part III in the “OFF”-state. The secondary outcome was cognitive function, measured with the Montreal Cognitive Assessment, Symbol Digit Modalities Test, and Letter-Number Sequencing task. Exposures of interest were diabetes mellitus, hypertension, body mass index, cardiovascular event history and hypercholesterolemia, and a modified Framingham risk score, measured at baseline. The effect of each of these exposures on disease progression was modeled using linear mixed models, including adjustment for identified confounders. A secondary analysis on the Tracking Parkinson's cohort including 1,841 patients was performed to validate our findings in an independent patient cohort.ResultsMean age was 61.4 years, and the average follow-up was 5.5 years. We found no statistically significant effect of any individual cardiovascular risk factor on the MDS-UPDRS part III progression (all 95% confidence intervals (CIs) included zero), with one exception: in the PD group, the estimated effect of a one-point increase in body mass index was 0.059 points on the MDS-UPDRS part III per year (95% CI: 0.017 to 0.102). We found no evidence for an effect of any of the exposures on the rate of change in cognitive functioning in the PD group. Similar results were observed for the Tracking Parkinson's cohort (all 95% CIs overlapped with PPMI), but the 95% CI of the effect of body mass index on the MDS-UPDRS part III progression included zero.ConclusionsBased on this analysis of two large cohorts of de novo PD patients, we found no evidence to support clinically relevant effects of cardiovascular risk factors on the clinical progression of Parkinson's disease.https://www.frontiersin.org/articles/10.3389/fneur.2023.1138546/fullParkinson's diseasecardiovascular riskdisease modificationlongitudinal modelingBMIhypertension |
| spellingShingle | Max J. Oosterwegel Max J. Oosterwegel Jesse H. Krijthe Melina G. H. E. den Brok Melina G. H. E. den Brok Lieneke van den Heuvel Edo Richard Edo Richard Tom Heskes Bastiaan R. Bloem Luc J. W. Evers Luc J. W. Evers The effect of cardiovascular risk on disease progression in de novo Parkinson's disease patients: An observational analysis Frontiers in Neurology Parkinson's disease cardiovascular risk disease modification longitudinal modeling BMI hypertension |
| title | The effect of cardiovascular risk on disease progression in de novo Parkinson's disease patients: An observational analysis |
| title_full | The effect of cardiovascular risk on disease progression in de novo Parkinson's disease patients: An observational analysis |
| title_fullStr | The effect of cardiovascular risk on disease progression in de novo Parkinson's disease patients: An observational analysis |
| title_full_unstemmed | The effect of cardiovascular risk on disease progression in de novo Parkinson's disease patients: An observational analysis |
| title_short | The effect of cardiovascular risk on disease progression in de novo Parkinson's disease patients: An observational analysis |
| title_sort | effect of cardiovascular risk on disease progression in de novo parkinson s disease patients an observational analysis |
| topic | Parkinson's disease cardiovascular risk disease modification longitudinal modeling BMI hypertension |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2023.1138546/full |
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