Moderating effects of uric acid and sex on cognition and psychiatric symptoms in asymmetric Parkinson's disease.

Publisher: BioMed Central Country of Publication: England NLM ID: 101548963 Publication Model: Electronic Cited Medium: Internet ISSN: 2042-6410 (Electronic) Linking ISSN: 20426410 NLM ISO Abbreviation: Biol Sex Differ Subsets: MEDLINE

Original Publication: London : BioMed Central, 2010-

Parkinson Disease*/diagnosis ; Parkinson Disease*/metabolism ; Parkinson Disease*/psychology ; Mental Disorders*; Humans ; Male ; Female ; Uric Acid ; Functional Laterality ; Cognition

Background: Non-motor symptoms are an important early feature of Parkinson's disease (PD), encompassing a variety of cognitive and psychiatric symptoms that seem to manifest differently depending on motor symptom asymmetry. Different factors, such as uric acid (UA) and sex, seem to influence cognitive and psychiatric expression in PD, however their interplay remains to be better understood.
Methods: Participants taking part in the Parkinson's Progression Marker Initiative were studied based on the side of motor symptom asymmetry and sex. Three-way interaction modeling was used to examine the moderating effects of sex and UA on cognitive functions and psychiatric symptoms.
Results: Significant three-way interactions were highlighted at 1-year follow-up between motor symptom asymmetry, UA and sex for immediate and long-term memory in female patients exhibiting predominantly left-sided motor symptoms, and for processing speed and sleepiness in female patients exhibiting predominantly right-sided motor symptoms. No significant interactions were observed for male patients. Moreover, female patients exhibiting predominantly right-sided motor symptoms demonstrated lower serum UA concentrations and had overall better outcomes, while male patients with predominantly right-sided motor symptoms demonstrated particularly poor outcomes.
Conclusions: These findings suggest that in the earliest stages of the disease, UA and sex moderate cognitive functions and psychiatric symptoms differently depending on motor asymmetry, holding important clinical implications for symptom management in patients.
(© 2023. The Author(s).)

Mov Disord. 2013 May;28(5):663-7. (PMID: 23238827)
Neuroimage. 2020 Nov 15;222:117215. (PMID: 32745674)
Lancet Neurol. 2017 Nov;16(11):908-916. (PMID: 28958801)
Parkinsonism Relat Disord. 2018 Oct;55:50-54. (PMID: 29779681)
Eur J Neurol. 2013 Jan;20(1):16-34. (PMID: 23279440)
Neuroepidemiology. 2011;36(4):223-9. (PMID: 21677446)
Curr Opin Rheumatol. 2018 Mar;30(2):183-187. (PMID: 29389776)
Laterality. 2015;20(1):112-27. (PMID: 25341015)
Front Aging Neurosci. 2021 Feb 25;13:625690. (PMID: 33716713)
Neurology. 2021 Feb 9;96(6):e895-e903. (PMID: 33408141)
J Psychiatr Res. 1982-1983;17(1):37-49. (PMID: 7183759)
Brain Behav. 2016 Oct 19;7(1):e00590. (PMID: 28127512)
J Parkinsons Dis. 2020;10(3):1003-1010. (PMID: 32444561)
Exp Neurol. 2017 Dec;298(Pt B):210-224. (PMID: 28622913)
Parkinsonism Relat Disord. 2017 Feb;35:69-74. (PMID: 28017549)
Medicine (Baltimore). 2017 Nov;96(45):e8502. (PMID: 29137045)
Neuropsychologia. 2020 Jul;144:107494. (PMID: 32413433)
PLoS One. 2013 May 03;8(5):e62793. (PMID: 23658775)
Neurology. 1967 May;17(5):427-42. (PMID: 6067254)
Neuropsychologia. 2022 Dec 15;177:108419. (PMID: 36375651)
J Clin Neurosci. 2015 Aug;22(8):1264-7. (PMID: 26055955)
Mov Disord. 2010 Jan 15;25(1):70-5. (PMID: 20014110)
Arch Clin Neuropsychol. 1992 Nov;7(6):471-80. (PMID: 14591398)
Arch Clin Neuropsychol. 2023 Feb 16;:. (PMID: 36796803)
J Geriatr Psychiatry Neurol. 2013 Jun;26(2):95-104. (PMID: 23584852)
J Parkinsons Dis. 2014;4(3):499-505. (PMID: 24784037)
Nat Rev Neurosci. 2017 Jul;18(7):435-450. (PMID: 28592904)
Neuropsychologia. 2017 Jul 28;102:177-189. (PMID: 28647437)
Neuroepidemiology. 2013;41(1):29-34. (PMID: 23548762)
Mov Disord. 2007 Jan;22(1):41-7. (PMID: 17115387)
Mov Disord. 2015 Dec;30(14):1921-5. (PMID: 26408124)
Prog Neuropsychopharmacol Biol Psychiatry. 2004 Jan;28(1):1-13. (PMID: 14687851)
Neurol Sci. 2016 May;37(5):743-7. (PMID: 26753800)
Eur Neurol. 2014;72(3-4):223-7. (PMID: 25247752)
Intern Emerg Med. 2015 Feb;10(1):25-31. (PMID: 24986078)
J Am Geriatr Soc. 2005 Apr;53(4):695-9. (PMID: 15817019)
Clin Neurol Neurosurg. 2009 Nov;111(9):724-8. (PMID: 19632030)
Cogn Affect Behav Neurosci. 2022 Oct;22(5):1030-1043. (PMID: 35474566)
Parkinsonism Relat Disord. 2015 Sep;21(9):1096-100. (PMID: 26173702)
Sci Rep. 2022 Feb 22;12(1):3007. (PMID: 35194127)
J Clin Exp Neuropsychol. 2013;35(2):124-31. (PMID: 23216295)
Can J Neurol Sci. 1992 May;19(2):163-9. (PMID: 1623440)
Lancet Neurol. 2018 Jun;17(6):559-568. (PMID: 29699914)
Int J Med Sci. 2018 Jun 23;15(10):1072-1082. (PMID: 30013449)
Exp Gerontol. 2010 May;45(5):331-5. (PMID: 20080169)
Eur J Neurol. 2015 Jan;22(1):93-8. (PMID: 25104282)
Parkinsons Dis. 2021 Apr 1;2021:8898887. (PMID: 33868631)
Mov Disord. 2021 Oct;36(10):2303-2313. (PMID: 34124799)
Front Syst Neurosci. 2011 Nov 24;5:92. (PMID: 22287944)
Can J Neurol Sci. 2013 Jan;40(1):73-9. (PMID: 23250131)
Sleep. 1991 Dec;14(6):540-5. (PMID: 1798888)
Front Neurol. 2019 Jan 07;9:1149. (PMID: 30666229)
Parkinsonism Relat Disord. 2009 May;15(4):315-7. (PMID: 18793864)
Neurologia (Engl Ed). 2021 Mar 13;:. (PMID: 33726970)
Brain Res. 2020 Jan 1;1726:146486. (PMID: 31580872)
Exp Gerontol. 2014 Dec;60:136-9. (PMID: 25446978)
Prog Neurobiol. 2011 Dec;95(4):629-35. (PMID: 21930184)
Arch Neurol. 1978 Jun;35(6):364-7. (PMID: 655909)
Medicina (Kaunas). 2021 Sep 16;57(9):. (PMID: 34577895)
J Int Neuropsychol Soc. 2006 Sep;12(5):736-40. (PMID: 16961953)
Trends Cogn Sci. 2014 Apr;18(4):177-85. (PMID: 24440116)
Cell Tissue Res. 2018 Jul;373(1):297-312. (PMID: 29656343)
Brain. 2008 Nov;131(Pt 11):2882-93. (PMID: 18957454)
Brain Behav. 2016 Oct 06;6(12):e00573. (PMID: 28031997)
Cereb Cortex. 2012 May;22(5):1124-32. (PMID: 21810782)
Mov Disord. 2020 Mar;35(3):409-418. (PMID: 31755149)
Behav Res Methods. 2007 Nov;39(4):709-22. (PMID: 18183883)

Keywords: Cognition; Motor symptom asymmetry; Parkinson’s disease; Psychiatric symptoms; Three-way interaction models; Uric acid
Local Abstract: [plain-language-summary] Parkinson’s disease is characterized by motor symptoms that usually manifest in an asymmetrical fashion. Given this motor symptom asymmetry, it is possible to distinguish patients that exhibit predominantly right-sided motor symptoms from those that exhibit predominantly left-sided motor symptoms. Patients also often develop non-motor symptoms, such as cognitive and psychiatric complaints. Recent studies have found that non-motor symptoms can manifest differently depending on motor symptom asymmetry. Furthermore, different factors, such as uric acid, a natural antioxidant in the human body, and the patient’s sex seem to influence cognitive and psychiatric manifestations, however their interplay remains to be better understood. The present study aimed to examine the interactions between motor symptom asymmetry, serum uric acid and patient’s sex on the manifestation of cognitive and psychiatric symptoms. Using regression models, it was found that at 1 year from diagnosis, uric acid and sex moderated cognitive and psychiatric symptoms differently according to motor symptom asymmetry. Indeed, female patients with predominantly left-sided motor symptoms had better memory performances with lower concentrations of serum uric acid, whereas female patients with predominantly right-sided symptoms presented better psychomotor speed and less sleepiness with higher concentrations of uric acid. Moreover, female patients with predominantly right-sided motor symptoms had overall better outcomes, while male patients with predominantly right-sided motor symptoms demonstrated particularly poor clinical outcomes. These findings suggest that in the earliest stages of the disease, uric acid and sex moderate cognitive and psychiatric symptoms differently depending on motor asymmetry, holding important clinical implications for symptom management in patients.

268B43MJ25 (Uric Acid)

Date Created: 20230504 Date Completed: 20230508 Latest Revision: 20230609

20240628

PMC10157998

10.1186/s13293-023-00510-1

37143121