Frequency and Evolution of Non Motor Signs in Early Parkinson's Disease. A Prospective Case-Control Study
Coordinating Institution:
Centre Hospitalier de Luxembourg
Other Partner(s):
Brüderkrankenhaus Trier (D)
From: 01/01/2007
To: 30/06/2010
Budget: 249,000.00€
Contact(s):
Diederich Nico J.
Summary
In this prospective longitudinal study patients with recent onset of Parkinson’s Disease (PD) are compared with age matched control subjects in order to find out if subclinical non-motor signs can be early disease markers. Visual and olfactory systems as well as different cognitive domains are directly explored while dysautonomic symptoms and sleep complaints are investigated by questionnaires. A polysomonography (PSG) is performed. In a subgroup of patients we shall further evaluate facial recognition capacities, decision strategies and subclinical striatal hyperechogenicity. We plan to repeat the test battery in two, and possibly, five years.
At a first stage we performed a pilot study in order to evaluate the feasibility and the public interest for the study. There were 41 participants. Detailed preliminary results could already be presented at international congresses (see above). Here a summary of these results:
- There are significant deficits of olfaction and vision (colour and contrast discrimination) in early PD patients when compared to age-matched controls.
- PD patients show a significant loss of the physiological muscle atonia during REM sleep
- PD patients show subtle executive dysfunction for problem solving / conceptualization, inhibition and psychomotor speed.
- Dysautonomic features are not discriminative.
The second stage of the study started in July 2007, A recruitment of 120 participants- 60 PD patients and 60 control subjects- has been planned. At the end of 2008, a total of 72 control subjects have participated and 58 PD patients have agreed to participate. Almost all of them have undergone the sensory and psychological test phase. A total of 80 participants have passed PSG. This test phase is presently almost finished.
New results
- Confirmation of the deficits of olfaction and vision in the larger cohort
- Surprisingly visual deficits alone have the best discriminative power
- A substantial subgroup of early PD patients also show deficits of emotional face recognition, especially concerning disgust and anger
- At an early stage of PD the primary visual deficits are not (yet) linked to higher order visual deficits.
The third stage
Meanwhile, we began to retest the participants who had passed the test-battery two years ago. 21 subjects have been tested at the end of 2008. it is our goal to complete this phase at the end of 2008, if the FNR authorizes a prolongation of the study.
Published Posters:
- Diederich NJ, Pieri V, Blyth S, Hipp G, Vaillant M. Discriminative power of different non-motor signs for early diagnosis of idiopathic Parkinson s disease. A case-control study. Neurology 2008; 70 (Suppl 1) A 398.
- Pieri V, Vaillant M, Blyth S, Hipp G, Diederich NJ. Are there multisensory deficits in early Parkinson’s disease? A case-control study. Parkinsonism and Relat Disord 2007; 13 (Suppl 2) S40-41.
- Hipp G, Vaillant M, Blyth S, Pieri V, Diederich NJ. Subtle executive dysfunction in early Parkinson’s disease: A case-control study. Parkinsonism Relat Disord 2007; 13 (Suppl 2) S57.
- Diederich NJ, Vaillant M, Rufra O, Blyth S and Pieri V: Searching for subtle sleep abnormalities by polysomnography in early Parkinson’s disease. A prospective case-control study. Mov Disord 2007; 22 (Suppl 16). S 166.
Other Communications:
Diederich NJ. Nicht-motorische Symptome als prämotorische Symptome bei M. Parkinson Was ist gesichert? Second Parkinson-Symposium at the University of Cologne. Cologne, October 27, 2007.Diederich NJ, Rufra O, Tiete J, Lyen P, Schlesser M, Nati R, Vaillant M: Unraveling the secrets of sleep dysfunction in Parkinson’s disease; the contribution of polysomnography. BASS Spring meeting on “Sleep and health”, Mondorf (Luxembourg), May, 2007.