Pei-Chen Lee1,2,3, Fanny Artaud4, Florence Cormier-Dequaire5,6,7, Olivier Rascol7,8, Franck Durif7,9, Pascal Derkinderen7,10, Ana-Raquel Marques7,9, Frédéric Bourdain11, Jean-Philippe Brandel12, Fernando Pico13, Lucette Lacomblez5,6,7, Cecilia Bonnet5,6,7, Christine Brefel-Courbon7,8, Fabienne Ory-Magne7,8, David Grabli5,6,7, Stephan Klebe14, Graziella Mangone5,6,7, Hana You5,6,7, Valérie Mesnage15, Alexis Brice5,6,7, Marie Vidailhet5,6,7, Jean-Christophe Corvol5,6,7, Alexis Elbaz4. 1. Department of Health Care Management, College of Health Technology, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan. 2. Preventive Medicine Research Center, National Yang-Ming University, Taipei, Taiwan. 3. Taipei City Hospital, Taipei, Taiwan. 4. CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, 94805, Villejuif, France. 5. Department of Neurology and Genetics, Hôpital Pitié-Salpêtrière, Assistance Publique Hôpitaux de Paris, F-75013, Paris, France. 6. Sorbonne Université, INSERM, Institut du cerveau et de la Moelle, Centre d'Investigation Clinique Neurosciences, CNRS, Paris, France. 7. NS-PARK/FCRIN Network, Paris, France. 8. Universityof Toulouse 3, Centre Hospitalo-Universitaire de Toulouse and INSERM; Centre d'Investigation Clinique CIC1436, Départements de Neurosciences et de Pharmacologie Clinique, NeuroToul COEN center, Toulouse, France. 9. Department of Neurology, Centre Hospitalo-Universitaire de Clermont-Ferrand, Clermont-Ferrand, France. 10. Department of Neurology, Centre Hospitalo-Universitaire de Nantes, Nantes, France. 11. Department of Neurology, Hôpital Foch, Suresnes, France. 12. Department of Neurology, Fondation Rothschild, Paris, France. 13. Department of Neurology, Centre Hospitalier de Versailles; and Université Versailles Saint Quentin en Yvelines et Paris Saclay, Versailles, France. 14. Department of Neurology, University Hospital Essen, Essen, Germany. 15. Department of Neurology, Centre Hospitalo-Universitaire Saint-Antoine, Paris, France.
Abstract
BACKGROUND: Whether reserve plays a role in Parkinson's disease (PD) patients has received less attention than in dementia and has been mainly examined in relation with cognitive function. OBJECTIVE: To investigate whether reserve plays a role in the severity and progression of motor, cognitive, and nonmotor PD symptoms by examining whether education level (proxy of reserve) is associated with baseline performance and rate of progression. METHODS: We used data from a longitudinal cohort of PD patients (≤5-year disease duration at baseline) annually followed up to 5 years (n = 393; 41% women; mean age = 62.3 years, standard deviation = 10.0; mean disease duration = 2.6 years, standard deviation = 1.5). We examined the relationship of education with time to reach Hoehn and Yahr stage ≥3 using Cox regression and with baseline severity and progression of motor (Movement Disorder Society-Unified Parkinson's Disease Rating Scale parts II and III, gait speed), cognitive (Mini-Mental State Examination), and nonmotor (depression, anxiety, nonmotor symptoms scale, quality of life) symptoms using mixed models. RESULTS: Education level was not associated with age at onset or diagnosis. Compared with the low-education group, the incidence of Hoehn and Yahr ≥3.0 was 0.42 times lower (95% confidence interval, 0.22-0.82, P = 0.012) in the high-education group. Higher education was associated with better baseline motor function (P < 0.001), but not with the rate of motor decline (P > 0.15). Similar results were observed for cognition. Education was not associated with nonmotor symptoms. CONCLUSIONS: Higher education is associated with better baseline motor/cognitive function in PD, but not with rate of decline, and with a lower risk of reaching Hoehn and Yahr ≥3 during the follow-up. Our observations are consistent with a passive reserve hypothesis for motor/cognitive symptoms.
BACKGROUND: Whether reserve plays a role in Parkinson's disease (PD) patients has received less attention than in dementia and has been mainly examined in relation with cognitive function. OBJECTIVE: To investigate whether reserve plays a role in the severity and progression of motor, cognitive, and nonmotor PD symptoms by examining whether education level (proxy of reserve) is associated with baseline performance and rate of progression. METHODS: We used data from a longitudinal cohort of PDpatients (≤5-year disease duration at baseline) annually followed up to 5 years (n = 393; 41% women; mean age = 62.3 years, standard deviation = 10.0; mean disease duration = 2.6 years, standard deviation = 1.5). We examined the relationship of education with time to reach Hoehn and Yahr stage ≥3 using Cox regression and with baseline severity and progression of motor (Movement Disorder Society-Unified Parkinson's Disease Rating Scale parts II and III, gait speed), cognitive (Mini-Mental State Examination), and nonmotor (depression, anxiety, nonmotor symptoms scale, quality of life) symptoms using mixed models. RESULTS: Education level was not associated with age at onset or diagnosis. Compared with the low-education group, the incidence of Hoehn and Yahr ≥3.0 was 0.42 times lower (95% confidence interval, 0.22-0.82, P = 0.012) in the high-education group. Higher education was associated with better baseline motor function (P < 0.001), but not with the rate of motor decline (P > 0.15). Similar results were observed for cognition. Education was not associated with nonmotor symptoms. CONCLUSIONS: Higher education is associated with better baseline motor/cognitive function in PD, but not with rate of decline, and with a lower risk of reaching Hoehn and Yahr ≥3 during the follow-up. Our observations are consistent with a passive reserve hypothesis for motor/cognitive symptoms.
Authors: Seok Jong Chung; Han Soo Yoo; Hye Sun Lee; Yang Hyun Lee; KyoungWon Baik; Jin Ho Jung; Byoung Seok Ye; Young H Sohn; Phil Hyu Lee Journal: J Neurol Date: 2021-05-04 Impact factor: 4.849
Authors: Daniela Berg; Per Borghammer; Seyed-Mohammad Fereshtehnejad; Sebastian Heinzel; Jacob Horsager; Eva Schaeffer; Ronald B Postuma Journal: Nat Rev Neurol Date: 2021-04-20 Impact factor: 42.937
Authors: Katerina Markopoulou; Jan Aasly; Sun Ju Chung; Efthimios Dardiotis; Karin Wirdefeldt; Ashvini P Premkumar; Bernadette Schoneburg; Ninith Kartha; Gary Wilk; Jun Wei; Kelly Claire Simon; Samuel Tideman; Alexander Epshteyn; Bryce Hadsell; Lisette Garduno; Anna Pham; Roberta Frigerio; Demetrius Maraganore Journal: Front Neurol Date: 2020-07-07 Impact factor: 4.003