Predictors for early-onset psychotic symptoms in patients newly diagnosed with Parkinson's disease without psychosis at baseline: A 5-year cohort study.

Journal: CNS neuroscience & therapeutics

Volume: 30

Issue: 3

Year of Publication: 2024

Affiliated Institutions:  Department of Neurology, Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University, Beijing, China. Department of Neurology, PF Center of Excellence, UC Davis Medical Center, UC Davis School of Medicine, Sacramento, California, USA.

Abstract summary 

To investigate the risk factors for early-onset psychosis in Parkinson's disease (PD) in a cohort of patients from the Parkinson's Progression Markers Initiative.Longitudinal data on motor and non-motor features, dopamine transporter (DAT) imaging, and cerebrospinal fluid (CSF) measurements were collected. The survival probability of psychotic symptoms, potential risk factors for psychosis development over a 5-year follow-up period, and the performance of the prediction model were evaluated.Among the 338 newly diagnosed patients with PD, 83 developed psychotic symptoms. Gastrointestinal autonomic dysfunction, presence of probable rapid-eye-movement sleep behavior disorder, and the ratio Aβ42: total-tau could independently predict onset of psychosis in PD (hazard ratio (HR) = 1.157, 95% confidence interval (CI) 1.022-1.309, p = 0.021, HR = 2.596, 95% CI 1.287-5.237, p = 0.008, and HR = 0.842, 95% CI 0.723-0.980, p = 0.027, respectively). The combined model integrating baseline clinical predictors, DAT imaging, and CSF measurements achieved better sensitivity than the clinical predictors alone (area under the curve = 0.770 [95% CI 0.672-0.868] vs. 0.714 [95% CI 0.625-0.802], p = 0.098).We identified clinical and CSF predictors of early-onset psychosis in patients with PD. Our study provides evidence and implications for prognostic stratification and therapeutic approaches for PD psychosis.

Authors & Co-authors:  Chen Chen Zhao Feng Wang Li Chen Bai Guo He Zhang Yuan

Study Outcome 

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Statistics
Citations :  Bloem BR, Okun MS, Klein C. Parkinson's disease. Lancet. 2021;397(10291):2284‐2303. doi:10.1016/S0140-6736(21)00218-X
Authors :  12
Identifiers
Doi : e14651
SSN : 1755-5949
Study Population
Male,Female
Mesh Terms
Humans
Other Terms
Aβ42: Total-tau;Parkinson's disease;RBD;gastrointestinal autonomic dysfunction;psychosis
Study Design
Cohort Study,Cohort Study,Cohort Study,Cohort Study,Cohort Study,Cohort Study
Study Approach
Country of Study
Publication Country
England