Objective: To examine the relation between education and dopamine signal loss in PD.

Background: In support of the cognitive reserve concept, it has consistently been shown that higher educated Alzheimer’s disease patients tolerate more severe brain pathology than lower educated patients despite similar clinical impairment. Here, we examined whether higher education is associated with more severe dopamine loss at the point of diagnosis of PD.

Method: Data of 414 PD patients were retrieved from the PPMI database. Main inclusion criteria were: 1) > 50 years of age, 2) asymmetrical putaminal DaT signal, 3) symptom laterality contralateral of more affected hemisphere, 4) MoCa > 24. Dopamine signal of the left and right putamen, caudate and striatum was re-coded into more (MAH) and less (LAH) affected hemisphere depending on the asymmetry of the putaminal DaT signal. First, partial correlation analyses were performed between years of education and regional DaT SPECT signal while correcting for motor symptom severity (UPDRS-III, age, sex and cognition (MoCA)). Second, three groups were determined based on a median split on education (Md=16 yrs): lower (< 16 yrs), medium (=16 yrs) and higher (> 16 yrs) education. The medium education group was excluded and the lower and higher education group were matched for age, sex, MoCA and UPDRS-III score using propensity score matching in R studio. Regional dopamine signals were compared between the matched groups. Importantly, correlations and group comparisons were performed across the entire cohort and separately for three age ranges (fifth [n=122], sixth [n=210] and seventh [n=78] decade of life).

Results: Across the cohort and in patients in their fifth or sixth decade of life, no significant association was observed between years of education and regional dopamine signal loss. Yet, a positive association between education and the putaminal dopamine signal in the MAH (p=.024, r=.260) and LAH (p=.039, r=.240) was found in patients in their seventh decade of life. This observation was supported by significantly higher putaminal signal of the MAH (W=181, p=.027) in the higher educated compared to the lower educated 70+ group.

Conclusion: Higher education is not generally related with greater tolerance against dopamine loss in PD, but may nonetheless assert protective effects at more advanced age.

« Back to 2023 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/education-and-the-motor-effects-of-dopamine-loss-in-parkinsons-disease/