Association of Liver Fibrosis with Motor Deficits in Parkinson's Disease (P2-5.020).
Academic Article
Overview
abstract
OBJECTIVE: To determine the impact of liver fibrosis on motor symptoms in Parkinson's disease. BACKGROUND: Parkinson's disease motor symptoms can vary with systemic illnesses. Liver disease is associated with parkinsonism, but the impact of hepatic dysfunction on the motor manifestations of Parkinson's disease remains unknown. DESIGN/METHODS: We conducted a retrospective cohort study using data from the Parkinson's Progression Markers Initiative. Liver disease was defined using the validated Fibrosis-4 (FIB-4) score. Our primary outcome was the association of the baseline FIB-4 score with Unified Parkinson's Disease Rating Scale (UPDRS) part 3 score. Additional outcome measures were the UPDRS part 2 and 4 scores, Hoehn and Yahr stages and levodopa equivalent daily dose. We used linear regression models to assess the relationship between liver fibrosis and motor scores at baseline and linear mixed models to evaluate the association between baseline FIB-4 score and the rate of change in motor function over five years. Models were adjusted for demographics, comorbidities, alcohol use, time since Parkinson's disease diagnosis, and genetic predisposition. RESULTS: We included 360 people with Parkinson's disease (mean age 61.8, 41.1% women). There was a significant association between liver fibrosis and baseline UPDRS part 3 score (β=2.3, 95% CI: 0.2, 4.5). Five years later, there was no significant association between baseline FIB-4 and motor assessment scores. In the subset of patients with elevated FIB-4 scores, the rate of change in UPDRS part 3 scores was slower. There was no association between FIB-4 score and the rate of progression of other motor symptoms. CONCLUSIONS: In people with Parkinson's disease, the presence of comorbid liver fibrosis was associated with more severe motor dysfunction early, but not later, in their disease course. Further work is required to determine the underlying mechanism. Disclosure: Dr. Zolin has nothing to disclose. Dr. Ooi has nothing to disclose. Dr. Zhou has nothing to disclose. Prof. Su has nothing to disclose. An immediate family member of Fei Wang, PhD has received personal compensation for serving as an employee of IBM. Fei Wang, PhD has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for IBM. Fei Wang, PhD has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Boerhinger Ingelheim. The institution of Fei Wang, PhD has received research support from NSF. The institution of Fei Wang, PhD has received research support from MJFF. The institution of Fei Wang, PhD has received research support from NIH. The institution of Dr. Sarva has received research support from Insightec. The institution of Dr. Sarva has received research support from NeuroNext. The institution of Dr. Sarva has received research support from Neuroderm. The institution of Dr. Sarva has received research support from Sun Pharma. The institution of Dr. Sarva has received research support from Prevail. The institution of Dr. Sarva has received research support from Bluerock Therapeutics. The institution of Dr. Sarva has received research support from Biogen. The institution of Dr. Sarva has received research support from Roche. The institution of Dr. Sarva has received research support from National Institute of Aging. The institution of Dr. Sarva has received research support from Michael J Fox Foundation. The institution of Dr. Sarva has received research support from Novo Nordisk. The institution of Dr. Sarva has received research support from Bukwang. The institution of Dr. Sarva has received research support from Bial. The institution of Dr. Sarva has received research support from Cerevance. The institution of Dr. Sarva has received research support from UCB. The institution of Dr. Sarva has received research support from MeiraGTX. Disclaimer: Abstracts were not reviewed by Neurology® and do not reflect the views of Neurology® editors or staff.
