Relationship Between Head Trauma History and Motor Subtype in Early Parkinson's Disease

Background and Objectives: Head trauma (HT) has been suggested as a risk factor for Parkinson's disease (PD), but its impact on the motor and non-motor manifestations remains unclear. We investigated whether patients with early PD and a history of HT differ from those without HT in terms of their motor and non-motor symptom profiles. Materials and Methods: We enrolled patients with early PD (disease duration of ≤5 years, modified Hoehn and Yahr stages [mHY] 1-3). HT history was ascertained by structured questionnaire. Motor and non-motor symptoms were evaluated using standardized clinical rating scales. Motor subtypes-tremor-dominant (TD), akinetic-rigid (AR), and mixed-were determined according to established criteria based on the tremor-to-AR score ratio. Subtype distribution and motor scores were compared between HT and non-HT groups using univariate tests, mHY-adjusted ANCOVA, and multivariable models adjusting for age, sex, disease duration, education, mHY stage, MMSE, and BDI score. Results: Of 237 patients, 35 (14.8%) reported HT. The HT group had a higher mHY stage than the non-HT group and showed lower total and rest tremor scores on the Unified Parkinson's Disease Rating Scale, whereas rigidity scores were similar. Bradykinesia and gait/posture scores tended to be higher in the HT group, but these differences did not persist after adjustment for disease severity. The TD subtype was less frequent in the HT group than in the non-HT group (5.7% vs. 30.2%), whereas the AR subtype was more common (82.9% vs. 61.9%). The categorical subtype redistribution remained significant after multivariable adjustment (adjusted OR for AR vs. TD = 4.61, 95% CI 1.28-16.67). No detectable between-group difference in non-motor symptom burden was observed. Conclusions: In this single-center cross-sectional cohort, a self-reported history of HT in early PD was associated with a redistribution of motor phenotype categories toward AR-predominant presentations, with no detectable difference in non-motor symptom burden. Given the retrospective binary exposure assessment, these findings should be interpreted as hypothesis-generating, and prospective studies with structured exposure ascertainment are needed to clarify how HT may shape PD motor phenotype expression.