Objective: To evaluate the temporality, neuroanatomical correlates and prognostic significance of depression in PD using a large population cohort.

Background: Depression may be an important prognostic marker in Parkinson’s disease (PD).

Method: We identified individuals with PD in UKBiobank. We used regression models to establish risk of depression before and after PD diagnosis, and associations of depression with regional brain volumes, risk of incident dementia and all-cause mortality. Models were adjusted for age, sex, education, social isolation, deprivation, and PD duration.

Results: We identified 3970 individuals with PD (930 prevalent, 3040 incident), of whom 933 (23.5%) had a diagnosis of depression. Depression at enrolment in UKBiobank was associated with increased risk of incident PD (OR >1.5, p<0.01). Individuals with incident PD had a slightly increased risk of depression in the three years prior to diagnosis and a much greater risk of depression following diagnosis. Amongst incident PD cases, prodromal depression constituted a predominance of psychomotor symptoms and a lesser burden of anhedonia. Depression was associated with reduced grey matter volume in the thalamus and amygdala. Amongst individuals with incident PD, risk of all-cause mortality (beta 0.310, p<0.01) and dementia (beta 0.679, p<0.01) was greater in those with depression.

Conclusion: This large-scale prospective study demonstrated that depression predominately occurs following PD diagnosis, is a marker of subcortical neurodegeneration, and signals a poor prognosis in terms of both dementia and mortality.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/depression-in-parkinsons-disease-is-associated-with-subcortical-neurodegeneration-and-increased-risk-of-all-cause-mortality-and-dementia/