Abstract Details

Title Cognitive Outcomes in Glucocerebrosidase Mutation Associated Parkinson Disease

Topic Movement Disorders

Presentation(s) S13 - (-)

Poster/Presentation
Number 005

Background GBA-PD is associated with greater cognitive impairment and hallucinations. Whether this affects cognitive and psychiatric medication use is unknown.

Objective

Design/Methods PD subjects of Jewish descent with symptom onset from 1990-2009 were enrolled in a PD genetics study at Beth Israel Medical Center. After screening for the 8 common GBA mutations and excluding those with LRRK2 G2019S mutations or only one clinical visit, GBA-PD subjects (n=34) were age-of-onset and gender-matched to 1-2 IPD subjects (n=60). Following retrospective chart review, Cox proportional hazard models were applied to assess the risk of cholinesterase inhibitor use (>6 months), antipsychotic use (>6 months), report of impaired cognition (UPDRS I.1 ?2 >6 months), and report of hallucinations (UPDRS I.2 ? 2 ever and >6 months) in GBA-PD compared to IPD.

Results GBA-PD did not differ from IPD in gender (50.0% vs. 46.7%, p=0.76), median age of onset (57.5 vs. 59, p=0.44), disease duration (9.3 vs. 8.4, p=0.99), or levodopa equivalent dose at last visit (716 vs. 599, p=0.22). While the risks of cognitive impairment (HR=2.2; 95%CI: 0.8, 5.8), ever having hallucinations (HR=1.8; 95%CI: 0.9, 3.5), and being administered an antipsychotic for greater than 6 months (HR=1.9; 95%CI: 0.6, 5.8) were not significantly greater in GBA-PD, they were more likely to be administered a cholinesterase inhibitor for greater than 6 months (HR=3.1; 95%CI: 1.3, 7.2) and report hallucinations for greater than 6 months (HR=5.0; 95%CI: 1.5, 16.9).

Conclusions Patients with GBA-PD are more likely to be prescribed cholinesterase inhibitors and have sustained hallucinations compared to IPD. This likely reflects differences in pathophysiology, but it is possible that those with GBA-PD respond better to cholinesterase inhibitors.

Authors/Disclosures
Matthew J. Barrett, MD (Virginia Commonwealth University) PRESENTER	Dr. Barrett has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Springer Healthcare LLC. The institution of Dr. Barrett has received research support from Kyowa Kirin. The institution of Dr. Barrett has received research support from NIH.
Rolando J. Giannaula, MD	No disclosure on file
Vicki Shanker, MD, FAAN (Mount Sinai Beth Israel - PACC)	Dr. Shanker has received personal compensation in the range of $0-$499 for serving as a Consultant for The Insighters.
William L. Severt, MD, PhD (Leal Therapeutics)	Dr. Severt has received personal compensation for serving as an employee of AbbVie. Dr. Severt has stock in AbbVie.
Deborah Raymond (Beth Isreal Medical Center)	The institution of Ms. Raymond has received research support from NIH.
	No disclosure on file
	No disclosure on file
Laurie J. Ozelius, PhD	The institution of Dr. Ozelius has received research support from NIH. Dr. Ozelius has received intellectual property interests from a discovery or technology relating to health care.
Susan B. Bressman, MD, FAAN (Mount Sinai Health System)	The institution of Dr. Bressman has received research support from Michael J Fox Foundation . The institution of Dr. Bressman has received research support from NIH .
Rachel J. Saunders-Pullman, MD (Mount Sinai Beth Israel, Neurology, Downtown Union Square)	The institution of Dr. Saunders-Pullman has received research support from NIH, Bigglesworth Family Foundation, Empire Clinical Research Investigatory Program.

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