Objective: This study aims to explore clinical features and blood biochemical markers of apathy in PD.

Background: Apathy is one of the most common non-motor symptoms that cause severe burden and lower quality of life in patients with Parkinson’s disease (PD). Understanding its clinical features and early biochemical markers can help us better identify and manage apathetic patients with PD.

Method: A total of 201 patients with PD were enrolled and categorized into apathetic (n=99) and non-apathetic groups (n=102) using the Apathy Scale. Each patient underwent a comprehensive neurological examination. Fasting Blood samples were obtained to measure iron metabolism parameters, uric acid, homocysteine, folate, Vitamin B12, and 25 hydroxyvitamin D. Three Binary logistic regression models were performed to investigate the ability of demographic data and clinical assessments to predict apathetic individuals in PD. Receiver operator characteristic curves were further plotted to evaluate the accuracy of the predictive models.

Results: Ninety-nine (49.25%) patients were diagnosed as apathetic. The concentrations of transferrin (P = 0.001) and total iron binding capacity (P = 0.001) were lower in the apathetic groups than in the nonapathetic groups. No significant changes were observed in other biochemical parameters. Besides, apathetic participants were less educated (P=0.040) and had higher scores of MDS-UPDRS Part II(P=0.045) than nonapathetic patients. When considering non-motor symptoms, patients with apathy had significantly more severe cognitive status(P=0.039), higher scores of HAMD, HAMA, SCOPA-AUT, ESS, NMSS and PDQ-39 (P<0.05), as well as lower scores of PDSS(P=0.004). The logistic regression model which adjusted for age, sex, education levels, scores of HAMD, MMSE, MDS-UPDRS Part II, PDSS, SCOPA-AUT and NMSS yielded an 81.4% sensitivity and 66.0% specificity for distinguishing apathetic patients from nonapathetic patients(P＜0.001). Education levels (P=0.024) and scores of HAMD (P＜0.001) contributed significantly to the overall prediction model.

Conclusion: Apathy is common in PD, associating with more severe motor and non-motor symptoms. Disordered iron metabolism might play a role in apathy with PD. Education levels and depression were the strongest correlates of apathy in PD, which can be a reliable predictive indicator for apathy.

« Back to 2022 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/apathy-in-parkinsons-disease-serum-biochemical-markers-and-clinical-features/