Epilepsy and hearing loss early signs of Parkinson Disease finds JAMA study

UK: In a new study conducted by Cristina Simonet and the team, new temporal correlations between epilepsy and hearing loss and the development of Parkinson's' disease (PD) were discovered. The findings of this study were published in the Journal of American Medical Association - Neurology.

Early aspects of PD have been identified in population-based research, which overrepresents White, wealthy groups and may be generalizable. The goal of this study was to look at the relationship between pre-diagnostic manifestations and risk factors of Parkinson's disease in an ethnically diverse UK community with a substantial socioeconomic disadvantage but universal access to health care.

Nested case-control research was carried out on 1 016 277 patients from primary care practices in East London, utilizing electronic health care data to extract clinical information collected between 1990 and February 6, 2018. Between September 3, 2020, and September 3, 2021, the data was evaluated. Individuals with Parkinson's disease were compared to controls who did not have PD or other significant neurological diseases. A matched analysis (adjusted for age and gender) and an unmatched analysis (adjusted for age and gender) were conducted using multivariable logistic regression to assess relationships between risk variables and pre-diagnostic presentations to primary care with a future PD diagnosis. Three-time periods were studied independently and collectively.

The key findings of this study were as follow:

1. The study comprised 1055 patients with Parkinson's disease and 1 009 523 controls from a total of 1 016 277 people in the data set.

2. Patients with Parkinson's disease were older than controls and more male. In the matched study, relationships for tremor and memory problems less than 2 years before the PD diagnosis were discovered.

3. The connections were also discovered up to 10 years before the PD diagnosis for tremor and 5 years before the PD diagnosis for memory problems.

4. Among midlife risk factors, type 2 diabetes and hypertension were linked to a future diagnosis of Parkinson's disease.

5. There were additional associations with early nonmotor characteristics such as hypotension, constipation, and sadness.

6. There were associations discovered for epilepsy and hearing loss, both of which had not previously been widely reported.

7. These results were confirmed using data from the UK Biobank.

8. There was no correlation between ethnicity or deprivation index level and eventual PD diagnosis.

In conclusion, The prevalence of memory symptoms in this cohort implies an excess of cognitive impairment in early PD or difficulties appropriately identifying symptoms in typically underrepresented populations.

Reference:

Simonet C, Bestwick J, Jitlal M, et al. Assessment of Risk Factors and Early Presentations of Parkinson Disease in Primary Care in a Diverse UK Population. JAMA Neurol. Published online March 07, 2022. doi:10.1001/jamaneurol.2022.0003

Keywords: Parkinson's disease, epilepsy, tremor, memory problems, hearing loss, mood swings, hypotension, movement disorder, JAMA,