CLINICAL AND LABORATORY PREDICTORS OF RAPID PROGRESSION OF PARKINSON’S DISEASE

In Parkinson‘s disease (PD), several types of progression are conditionally distinguished. Determination of reliable criteria for identifying patients with a rapid type of PD progression in the early stages of the disease will allow us to begin the development of therapy aimed at inhibiting its development.

The aim of the study was to determine the clinical and laboratory predictors of the rapid type of PD progression in the Belarusian cohort of patients.

Patients with PD underwent a general somatic and neurological examination. Non-motor symptoms were assessed by completing the appropriate scales. Laboratory studies included the determination of antibodies to α-synuclein, the study of the levels of cortisol, IL-1β and IL-10, the calculation of the albumin coefficient (Qalb). Longitudinal study with three groups: 1) rapidly progressive type of PD, 2) slowly progressive, and 3) indeterminate. Candidate predictors were obtained by comparing clinical and laboratory parameters of patients with fast or slow types of PD progression. During dynamic monitoring of patients with an indeterminate type of progression, the sensitivity and specificity of predictors were determined.

113 people with PD: group 1 – 32 patients, group 2 – 26, group 3 – 55. Threshold values of indicators were obtained by comparing the clinical and laboratory characteristics of groups 1 and 2 by the Mann-Whitney method and then by ROC analysis to determine the probability of a fast type progression : Qalb less than 83.95, antibodies to α-synuclein in serum more than 4.11 ng/ml, MoCA less than 26 points. Depending on these indicators, patients of group 3 were divided into 2 subgroups: 3a) «possibly rapidly progressive» course (n = 21) and 3b) «possibly slowly progressive» course of PD (n = 34). In 16 (76%) patients from group 3a, the rapid type of progression was confirmed. In 28 (82%) patients from group 3b, a slow type of progression was confirmed.

The obtained results testify to the high sensitivity and specificity of the indicators. Further research is needed to develop therapies that change the course of PD.

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