Polyneuropathy May Signify More Severe Parkinson’s Disease

The following article is part of live conference coverage from the 2017 International Congress of Parkinson’s Disease and Movement Disorders (MDS) in Vancouver, British Columbia, Canada. Neurology Advisor’s staff will be reporting breaking news associated with research conducted by leading experts in neurology. Check back for the latest news from MDS 2017.

VANCOUVER — Parkinson’s disease-associated polyneuropathy (PD-PNP) may be a clinical marker of severe Parkinson’s, according to study results presented at the 2017 International Congress of Parkinson’s Disease and Movement Disorders.

Polyneuropathy is fairly common in Parkinson’s disease, with an overall prevalence of 19% to 55% compared with 8% to 9% in controls. Still, the mechanism behind this prevalence is not clear.

In this study, investigators from the University of Cincinnati in Ohio screened 200 patients with Parkinson’s disease, excluding those with alternative causes of PNP and those taking medications affecting the autonomic nervous system. Ultimately, 161 patients underwent the International Parkinson & Movement Disorders Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS), 4-limb nerve conduction studies, measurements of orthostatic blood pressure, and laboratory evaluations of vitamin B12, homocysteine, and folate, as well as the Montreal Cognitive Assessment, Non-Motor Symptoms Scale, and Scale for Outcomes in Parkinson’s Disease-Autonomic to assess for cognitive impairment, nonmotor symptoms, and autonomic state.

Overall, 29.2% of patients in the cohort had PD-PNP. After multivariate analysis accounting for levodopa equivalent daily dose, age, and disease duration, PD-PNP was found to be independently associated with cognitive impairment (P =.008), autonomic dysfunction (P =.035), nonmotor symptoms (P =.042), and axial motor features (P =.045) compared with those without PD-PNP.

The results suggest that PD-PNP may be a peripheral clinical marker of disease severity in PD. 

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