[P5.265] Lower Education Status Associates With Axial Motor Burden In Parkinson Disease

Vikas Kotagal, Roger Albin, Martijn Muller, Robert Koeppe, Kirk Frey, Nicolaas Bohnen
Ann Arbor, MI, USA


Background:
Lower educational status is a risk factor for dementia amongst elderly individuals. Axial motor impairments in Parkinson disease (PD) significantly influence mortality and quality of life and are typically less responsive to dopaminergic medications. Axial motor features are thought to be caused by neurodegeneration in extranigral systems whose varied underlying causes may share pathogenic overlap with mechanisms seen in other common dementing disorders.
Methods:
We performed a cross-sectional clinical-neuroimaging study of 85 subjects with Parkinson disease to explore the association between years of education and axial motor burden as determined by the summed 5-item Levy B criteria assessed using the Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) motor exam. Multivariable linear regression was used to control for possible confounders including subject age, disease duration, Montreal Cognitive Assessment (MoCA) score, total adjusted gray matter volume on T1-weighted MRI estimated using Freesurfer, and degree of nigrostriatal dopaminergic denervation estimated by striatal [11C]dihydrotetrabenazine (DTBZ) distribution volume ratio (DVR) relative to the neocortex.
Results:
The overall regression model significantly predicted axial motor burden (F=6.10, p<0.0001). Years of education (t=-2.10, p=0.0387), age (t=2.77, p=0.0071) and striatal DTBZ DVR (t=-2.74, p =0.0076) associated with axial motor burden severity. MoCA score (t=-0.89, p=0.3784), total adjusted gray matter volume (t=1.02, p=0.3086), and disease duration (t=1.86, p=0.0673) were not significant predictors in the multivariable model.
Conclusions:
Lower education status may be a risk factor for axial motor impairments in Parkinson disease. This effect is not fully explained by comorbid cognitive dysfunction, severity of dopaminergic denervation, or alterations in total grey matter volume and may relate to other unmeasured--and potentially alterable--factors including health behaviors and other risk factors more prevalent amongst those with lower educational status.
Supported by NIH grants PO1 NS015655, RO1 NS070856, Department of Veterans Affairs and the Michael J. Fox Foundation.
Category - Movement Disorders: Parkinson's Disease

Wednesday, April 30, 2014 3:00 PM

P5: Poster Session V: Movement Disorders: Cognition and Parkinson's Disease (3:00 PM-6:30 PM)

 

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