An increased rate of longitudinal cognitive decline is observed in Parkinson's disease patients with low CSF Aß42 and an APOE ?4 allele.
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ABSTRACT: OBJECTIVE:Low concentrations of cerebrospinal fluid (CSF) amyloid-beta (A?-42) are associated with increased risk of cognitive decline in Parkinson's disease (PD). We sought to determine whether APOE genotype modifies the rate of cognitive decline in PD patients with low CSF A?-42 compared to patients with normal levels. METHODS:The Parkinson's Progression Markers Initiative is a longitudinal, ongoing study of de novo PD participants, which includes APOE genotyping, CSF A?-42 determinations, and neuropsychological assessments. We used linear mixed effects models in three PD groups (PD participants with low CSF A? at baseline, PD participants with normal CSF A?, and both groups combined). Having at least one copy of the APOE ?4 allele, time, and the interaction of APOE ?4 and time were predictor variables for cognitive change, adjusting for age, gender and education. RESULTS:423 de novo PD participants were followed up to 5?years with annual cognitive assessments. 103 participants had low baseline CSF A?-42 (39 APOE ?4+, 64 APOE ?4-). Compared to participants with normal CSF A?-42, those with low CSF A?-42 declined faster on most cognitive tests. Within the low CSF A?-42 group, APOE ?4+ participants had faster rates of decline on the Montreal Cognitive Assessment (primary outcome; 0.57 points annual decline, p?=?.005; 5-year standardized change of 1.2) and the Symbol Digit Modalities Test (1.4 points annual decline, p?=?.002; 5-year standardized change of 0.72). DISCUSSION:PD patients with low CSF A?-42 and APOE ?4+ showed a higher rate of cognitive decline early in the disease. Tests of global cognition (Montreal Cognitive Assessment) and processing speed (Symbol Digit Modalities Test) were the most sensitive to early cognitive decline. Results suggest that CSF A?-42 and APOE ?4 might interact to promote early cognitive changes in PD patients.
SUBMITTER: Shahid M
PROVIDER: S-EPMC6588475 | biostudies-literature | 2019 Jul
REPOSITORIES: biostudies-literature
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