Reasons for mild parkinsonian signs - which constellation may indicate neurodegeneration?
Stefanie Lerche1, Kathrin Brockmann1, Isabel Wurster1
1Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tuebingen, Hoppe Seyler-Strasse 3, 72076 Tuebingen, Germany; German Center for Neurodegenerative Diseases, University of Tuebingen, Otfried-Müller-Str. 27, 72076 Tuebingen, Germany.
Introduction:
Mild parkinsonian signs (MPS) are common in the elderly population. Several factors including physical decline and comorbidities in addition to neurodegeneration may be possible sources for MPS. The objective was to examine whether MPS are associated with a history of orthopedic disturbances, vascular diseases or prodromal markers for neurodegeneration.
Methods:
The TREND study is a prospective longitudinal cohort study in individuals >50 years with biennial assessments designed to identify prodromal markers for neurodegeneration. In this substudy, 1091 elderly individuals were evaluated for a possible association of MPS with prodromal markers for neurodegeneration, orthopedic disturbances, vascular diseases, as well as cerebral abnormalities. These factors were assessed by self-administered questionnaires, with a structured health interview, a neurological examination and by transcranial sonography.
Results:
82 participants showed MPS. They were found to have more often hyposmia and RBD, had a higher autonomic dysfunction score and they more frequently showed hyperechogenicity of the substantia nigra compared to controls. Neither orthopedic disturbances nor vascular diseases were significantly associated with the prevalence of MPS.
Conclusion:
MPS might be a sign of early neurodegeneration rather than caused by other motor influencing diseases.
Insights
Mild parkinsonian signs (MPS) in older adults may indicate early neurodegeneration. These signs are linked to hyposmia, REM sleep behavior disorder (RBD), and autonomic dysfunction, not orthopedic or vascular issues.
Area of Science:
- Neurology
- Geriatrics
- Neurodegenerative Diseases
Background:
- Mild parkinsonian signs (MPS) are prevalent in the elderly.
- Potential causes include physical decline, comorbidities, and neurodegeneration.
- Understanding MPS origins is crucial for early diagnosis and intervention.
Purpose of the Study:
- To investigate the association between MPS and prodromal markers of neurodegeneration.
- To determine if orthopedic disturbances or vascular diseases contribute to MPS.
- To explore cerebral abnormalities in individuals with MPS.
Main Methods:
- Prospective longitudinal cohort study (TREND study) of individuals over 50.
- Substudy included 1091 elderly participants.
- Assessment via questionnaires, health interviews, neurological exams, and transcranial sonography.
Main Results:
- 82 participants presented with MPS.
- MPS associated with hyposmia, REM sleep behavior disorder (RBD), higher autonomic dysfunction scores, and substantia nigra hyperechogenicity.
- No significant association found between MPS and orthopedic disturbances or vascular diseases.
Conclusions:
- MPS may serve as an early indicator of neurodegeneration.
- Findings suggest MPS are linked to neurodegenerative processes rather than other motor disorders.
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