Objective: To determine the impact of daily caffeine consumption (presence, quantity) on the clinical phenotype of patients with Parkinson’s Disease (PD), focusing on age of onset, motor subtypes, L-Dopa response, and a broad range of non-motor symptoms.

Background: Caffeine is a known adenosine A2A receptor antagonist with potential neuroprotective properties. While its role in reducing PD risk is well-documented, its influence on the established clinical phenotype and the severity of non-motor symptoms remains a subject of ongoing clinical interest.

Method: A cross-sectional study was conducted using a specialized PD database gathered by assessing PD patients in the day-clinic at the department of Neurology of Sahloul hospital, Sousse, Tunisia. Patients were categorized by caffeine status (consumers vs. non-consumers), daily dose (number of cups/day). Clinical evaluation included age at onset, motor phenotype (tremor-dominant, PIGD, undetermined), and L-Dopa response/fluctuations. Non-motor symptoms were assessed via NMSS, MMSE (cognition), FAB (executive function), SCOPA-Aut (dysautonomia), RBD (sleep), and Beck/GDS (depression).

Results: Sixty-two patients were included (caffeine consumers= 42, non-consumers=20). Caffeine consumers demonstrated a significantly later age of motor symptom onset compared to non-consumers (63.2±8 versus 59.5±9, p=0.002). High caffeine intake (>2 cups/day) was associated with a higher prevalence of the tremor-dominant phenotype (p=0.015). Regarding L-Dopa response, consumers showed a shorter latency to “ON” state (p=0.008) and greater response to the L-Dopa acute test using 250mg (p=0.012) though no significant difference was found in the prevalence of dyskinesia. For non-motor symptoms, caffeine consumption correlated with significantly lower total NMSS scores (p=0.001) and better cognitive performance on the MMSE (p=0.004) and FAB test (p=0.013). No significant differences were observed for RBD or depression scales scores.

Conclusion: Regular caffeine consumption is associated with a delayed age of onset and a more favorable non-motor profile in PD patients and more benign motor phenotype (tremor-dominant). The faster and more efficacious response to L-Dopa among caffeine consumers suggests a potential pharmacokinetic or pharmacodynamic interaction that warrants further longitudinal investigation.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/impact-of-caffeine-consumption-on-clinical-phenotype-and-non-motor-symptoms-in-parkinsons-disease/