Abstract
IntroductionVariants in the GBA1 gene have been identified as a common risk factor for Parkinson’s disease (PD). In addition to pathogenic mutations (those associated with Gaucher disease), a number of ‘non-pathogenic’ variants also occur at increased frequency in PD. Previous studies have reported that pathogenic variants adversely affect the clinical course of PD. The role of ‘non-pathogenic’ GBA1 variants on PD course is less clear. In this study, we report the effect of GBA1 variants in incident PD patients with long-term follow-up.MethodsThe study population consisted of patients in the Cambridgeshire Incidence of Parkinson’s disease from General Practice to Neurologist and Parkinsonism: Incidence, Cognition and Non-motor heterogeneity in Cambridgeshire cohorts. Patients were grouped into non-carriers, carriers of ‘non-pathogenic’ GBA1 variants and carriers of pathogenic GBA1 mutations. Survival analyses for time to development of dementia, postural instability and death were carried out. Cox regression analysis controlling for potential confounders were used to determine the impact of GBA1 variants on these outcome measures.ResultsGBA1 variants were identified in 14.4% of patients. Pathogenic and ‘non-pathogenic’ GBA1 variants were associated with the accelerated development of dementia and a more aggressive motor course. Pathogenic GBA1 variants were associated with earlier mortality in comparison with non-carriers, independent of the development of dementia.DiscussionGBA1 variants, including those not associated with Gaucher disease, are common in PD and result in a more aggressive disease course.
Funder
Foundation for the National Institutes of Health
Van Geest Foundation
Patrick Berthoud Charitable Trust
Cure Parkinson's Trust
Michael J Fox Foundation
Innovate UK
Dooley LLC
American Parkinson's disease association
Medical Research Council
Cambridge Centre for Parkinson-Plus
Parkinson's UK
John Black charitable foundation
Wellcome Trust
National Institute for Health Research
Van Andel Research Institute
Subject
Psychiatry and Mental health,Neurology (clinical),Surgery
Cited by
59 articles.
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