Objective: To better characterize the relationship between salivary cortisol and psychological stress in persons with Parkinson’s disease (PD).

Background: Psychological stress is known to exacerbate the symptoms of PD and in animal models is deleterious to the nervous system.(Marsden 1967, Hemmerle 2012) Increased stress may contribute to the development of PD and to faster disease progression. Salivary cortisol is an objective measure of stress and is known to accurately reflex serum cortisol, however it has not been well characterized in PD. Better characterization in PD could assist in future studies examining the interplay of emotional stress and stress reduction in PD.

Methods: Saliva will be collected at awakening, 30 minutes after, at noon, and bedtime for three days. We will enroll four groups of 20 persons each: 1) persons with PD and high levels of stress, 2) PD and low levels of stress, 3) controls with high stress, and 4) controls with low stress. Psychological scales will include: the Perceived Stress Scale, and the Hamilton Anxiety and Depression Rating Scales. We will examine the correlation between measures on psychological scales and salivary cortisol. We will compare the awakening response (change in cortisol between awakening and 30 minutes after) and diurnal variation between the 3 groups.

Results: We have IRB approval and have enrolled over 70% of our target numbers. A preliminary analysis was presented at the 2017 AD/PD meeting. At approximately 50% of target enrollment the most notable data was a significant correlation between the cortisol awakening response in person’s with PD and high stress (R2=0.32, p=0.03) that was not seen in persons with PD and low stress (R2=0.30, p=0.10). We project to finish enrollment by early summer and analyze the additional cortisol samples in a batch at that time.

Conclusions: To successfully study the relationship between psychological stress and PD markers of target engagement are necessary. Salivary cortisol first needs to be better characterized in PD prior to using it as such a marker.

References: Marsden, C. D., and Owen, D. A. 1967. Mechanisms underlying emotional variation in parkinsonian tremor. Neurology 17 (7) (Jul): 711-5. Hemmerle, A. M., Herman, J.P., and Seroogy, K. B. 2012. Stress, depression and parkinson’s disease. Experimental Neurology 233 (1) (Jan): 79-86.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/measuring-salivary-cortisol-levels-in-persons-with-parkinsons-disease-pd/