Abstract Details

Title Monoaminergic Function and Anxiety, Depression, RBD, and Cognitive Impairment in Parkinson’s Disease

Topic Movement Disorders

Presentation(s) P7 - Poster Session 7 (11:45 AM-12:45 PM)

Poster/Presentation
Number 3-013

Objective To investigate the association between monoamine transporter binding and depression, anxiety, REM sleep behavior disorder (RBD) and cognition in early Parkinson’s disease (PD).

Background PD is associated with many neuropsychiatric symptoms but the neurobiological mechanisms of these symptoms are unclear. Some of the neuropsychiatric symptoms respond to serotonergic, noradrenergic or dopaminergic treatments, suggesting that monoamines have a role in these symptoms.

Design/Methods Data used in the preparation of this article were obtained from the Parkinson’s Progression Markers Initiative (PPMI) database (https://www.ppmi-info.org/access-data-specimens/download-data). For up-to-date information on the study, visit www.ppmi-info.org. The study included [¹²³I]-FP-CIT SPECT imaging of healthy controls (n=166) and patients with PD at baseline (n=349), 2-year follow-up (n=240), 4-year follow-up (n=140). Depression, anxiety, RBD and cognition were evaluated using GDS-15, STAI, RBDSQ, and MoCA, respectively. The SPECT data were registered to MNI space, and the association between the neuropsychiatric symptoms and monoamine transporter binding was analyzed voxel-by-voxel across brain regions with specific binding.

Results In PD patients, there were no significant association between the symptoms and [¹²³I]-FP-CIT specific binding at baseline. Depression was associated with reduced binding in the nucleus accumbens at 2- and 4-year follow-up, and dorsal raphe at 4-year follow-up. Trait anxiety was associated with reduced binding in the raphe nuclei at 4-year follow-up, and RBD in the nucleus accumbens at 2- and 4-year follow-up. These findings were replicated in region-of-interest-based analyses. In contrast, cognitive impairment was not associated with tracer binding. In controls, there were no significant associations between any of these symptoms and tracer binding.

Conclusions Our results show that depression, anxiety and RBD are associated with distinct monoaminergic abnormalities. These findings align with the known effects of serotonergic, noradrenergic and dopaminergic treatments and provide new information on the monoaminergic mechanisms underlying neuropsychiatric symptoms in PD.

Authors/Disclosures
Kalle J. Niemi, MD (University of Turku) PRESENTER	Dr. Niemi has stock in GSK. Dr. Niemi has stock in Modulight. Dr. Niemi has stock in Orion Corporation. Dr. Niemi has stock in Physicians Realty Trust. Dr. Niemi has stock in Nightingale Health. Dr. Niemi has received research support from The Finnish Parkinson Foundation (Suomen Parkinson-saatio). Dr. Niemi has received research support from The Sigrid Juselius Foundation (Sigrid Juselius -saatio). Dr. Niemi has received research support from The Finnish Neurological Association (Suomen Neurologinen Yhdistys).
Valtteri Kaasinen (Department of Neurology, Turku University Hos)	Valtteri Kaasinen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Nordic Infucare. Valtteri Kaasinen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abbvie. Valtteri Kaasinen has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Nordic Infucare. Valtteri Kaasinen has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Abbvie. Valtteri Kaasinen has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Nordic Infucare.
Juho Joutsa	No disclosure on file

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