Abstract Details

Title Head Injury and Parkinson’s Disease (PD) Phenotype

Topic Movement Disorders

Presentation(s) S17 - Parkinson's Disease Biomarkers and Pathophysiology (1:12 PM-1:24 PM)

Poster/Presentation
Number 002

Objective To determine the relationship between head injury and PD phenotype.

Background Determinants of phenotypic heterogeneity in PD are poorly understood, and may include both genetic and environmental factors. We investigated the relationship between head injury, a risk factor for PD, and clinical features, hypothesizing that head injury prior to PD would be associated with more severe phenotype.

Design/Methods Participants in the Parkinson’s Progression Markers Initiative (PPMI) and Fox Insight (FI) cohorts provided information about head injury and other exposures via online survey. Phenotype was determined using baseline MDS-UPDRS and 5-year change in MoCA in PPMI, and baseline self-reported MDS-UPDRS-II score and self-reported cognitive impairment in FI. We used parametric and non-parametric tests as appropriate, adjusted for age, sex, and smoking history.

Results 267 PPMI and 25,308 FI participants with PD provided head injury information. In PPMI, head injury before PD diagnosis was associated with higher non-motor symptom burden at enrollment (any injury: MDS-UPDRS-I mean 7.73 vs no injury: 6.19, p = 0.035; severe head injury: 8.29 vs no injury: 6.19, p = 0.051). Motor symptoms were higher among those with severe injury (MDS-UPDRS-II score 8.35 vs 6.42, p = 0.042). In 110 followed for 5 years, participants reporting severe head injury before diagnosis had a decline in cognitive function (mean change in MoCA -0.60 vs +0.76 no head injury, p = 0.048). FI participants reporting prior head injury had more motor symptoms (MDS-UPDRS-II 14.4 vs no head injury: 12.1, p <0.001). The risk of self-reported cognitive impairment was also elevated in FI participants reporting head injury (OR 1.58, 95% CI 1.27–1.97, p<0.001).

Conclusions Head injury prior to PD onset is associated with a more severe non-motor and motor phenotype. Additional longitudinal data will help elucidate whether this relationship may be causal or whether falling is an early indicator of worse symptoms.

Authors/Disclosures
Ethan G. Brown, MD (University of California, San Francisco) PRESENTER	Dr. Brown has received personal compensation in the range of $0-$499 for serving as a Consultant for Rune Labs, Inc. An immediate family member of Dr. Brown has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Novartis. Dr. Brown has received personal compensation in the range of $0-$499 for serving as a Consultant for Guidepoint Inc. An immediate family member of Dr. Brown has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. Dr. Brown has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for NEJM Knowledge Plus. Dr. Brown has stock in 153 Therapeutics. The institution of Dr. Brown has received research support from Michael J. Fox Foundation. The institution of Dr. Brown has received research support from NIH.
Samuel Goldman, MD, MPH	Dr. Goldman has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Littlepage Booth Leckman. The institution of Dr. Goldman has received research support from Michael J Fox Foundation. The institution of Dr. Goldman has received research support from US Department of Defense. The institution of Dr. Goldman has received research support from US Veterans Administration. The institution of Dr. Goldman has received research support from National Institutes of Health. The institution of Dr. Goldman has received research support from Health Resources and Services Administration. The institution of Dr. Goldman has received research support from American Academy of Pediatrics. Dr. Goldman has received personal compensation in the range of $100,000-$499,999 for serving as a Professor with University of California San Francisco. Dr. Goldman has received personal compensation in the range of $100,000-$499,999 for serving as a Staff Physician with San Francisco Veterans Affairs Health Care System.
	No disclosure on file
Caroline M. Tanner, MD, PhD, FAAN (University of California San Francisco, Weill Institute for Neurosciences)	Dr. Tanner has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Evidera. Dr. Tanner has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Neurocrine. Dr. Tanner has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Jazz Pharmaceuticals/Cavion. Dr. Tanner has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Bial . Dr. Tanner has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Supernus. Dr. Tanner has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche Genentech. The institution of Dr. Tanner has received research support from Gateway LLC. The institution of Dr. Tanner has received research support from Roche\Genentech. The institution of Dr. Tanner has received research support from Michael J Fox Foundation . The institution of Dr. Tanner has received research support from National Institute of Health . The institution of Dr. Tanner has received research support from Department of Defense. Dr. Tanner has received personal compensation in the range of $500-$4,999 for serving as a Faculty, CME presentation with Medscape /WebND.

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