Role of multimodal advanced biomarkers as potential predictors of cognitive and psychiatric aspects of Parkinson's disease

Abstract

Abstract Background The value of biomarker research in Parkinson's disease (PD) exists in the early detection and accurate diagnosis of non-motor neuropsychiatric symptoms with implications for future treatment strategies. The aim of the this work was to assess and predict risk for possible cognitive, psychiatric abnormalities in patients with early stage idiopathic PD using a combination of advanced diagnostic biomarkers for early recognition and intervention. Methods This cross-sectional case–control study was conducted on 58 eligible idiopathic PD-patients, and 45 age/sex-matched healthy controls. All participants were subjected to neuro-psychiatric-, radiological-, audiological-, and laboratory-evaluations. Cognitive assessment was performed using Montreal Cognitive Assessment, Mattis Dementia, and Parkinson’s Disease-Cognitive scales. Depression was evaluated by Hamilton Depression and Beck Depression Inventory-II rating scales. Radiologically, volumetric-MRI, diffusion tensor imaging (DTI), and susceptibility weighted imaging were done. Audiologically, P300 and cortical auditory evoked potentials were elicited. Laboratory investigations included 24 h-urinary 5-HIAA and serum levels of IL6, BDNF, 5-HT, and aberrant cimiRNA 132-3p expression profile. Results Neuropsychological scales revealed mild depression and mild cognitive impairment, with significant differences in PD group. Volumetric-MRI highlighted that PD-patients had a significant bilateral decrease in the mean cortical thickness and thickness/volume of many brain areas. DTI showed a reduction in fractional isotropy and a significant bilateral increase in mean diffusivity through many areas in PD-patients. Patients also had either absent or diminished amplitude of P300,P1, diminished amplitude of N1,P2,N2 and delayed latency of all previous waves. There was a significant reduction of 24 h-urinary 5-HIAA and serum BDNF, with significant elevation of serum IL6, as well as non-significant reduction of serum 5-HT and microRNA-132-3p(2-ΔCt) in PD-patients. Conclusions Early stage PD-patients had subtle cognitive impairment and depression as detected by psychometric scales and correlated significantly with the various biomarkers, including advanced neuro-imaging, evoked potential studies, and laboratory markers. The key message of this work include evaluating the high prevalence of cognitive and psychiatric impairment in early idiopathic PD has encouraged research and workup for precision medicine. Proper integration of advanced multimodal biomarkers in this study has led to predict the risk of early mild cognitive and psychiaric affection. This will optimize the health strategies for early proper management to improve quality of life.