Objective: To collect DNA and clinical, environmental and neuropsychiatric data in patients with PD in Pakistan and healthy controls.

Background: Parkinson’s disease (PD) is a growing concern in Pakistan, yet data on environmental exposures, cognition, and neuropsychiatric symptoms in this population remain limited. The London-Pakistan Parkinson`s project funded by the Global Parkinson’s Genetics Program (GP2) aims to characterize these factors to identify modifiable determinants of Parkinson`s disease severity and progression.

Method: LP-3 is a cross-sectional, case–control study recruiting 375 PD patients and 100 age-matched controls. Recruitment was initiated in January 2026 and is expected to continue through December 2026. Motor severity and disease staging are assessed using MDS-UPDRS staging. Cognitive function is measured with the Montreal Cognitive Assessment, RUDAS &CDR. Neuropsychiatric symptoms, including depression, anxiety, and psychosis, are evaluated using the Hospital Anxiety and Depression Scale and Neuropsychiatric Inventory Questionnaire . Environmental exposures are assessed using the Mini-MERQ questionnaire. Biological samples, including DNA, RNA, plasma, and cerebrospinal fluid, are collected for biomarker and genetic analyses, with genotyping conducted in collaboration with GP2.

Results: Pilot data from the initial recruitment phase (n=27 till 10th March 2026) demonstrate feasibility of comprehensive environmental, cognitive, and psychiatric phenotyping. Preliminary trends suggest early cognitive decline in participants with higher motor severity and mild neuropsychiatric symptoms in a subset. Reporting of environmental exposures was variable, emphasizing the need for complete recruitment to clarify potential associations with disease severity.

Conclusion: LP-3 is the first large-scale study in Pakistan to integrate genetic, clinical and environmental assessments in PD. Ongoing recruitment and pilot findings support feasibility and highlight the potential impact of cognition, psychiatric symptoms, and environmental factors on disease outcomes(Fig 1, 2 &3). Recruitment is expected to be completed by December 2026 which will allow robust analyses to identify culturally relevant risk factors and determinants of PD in this population.

Fig 1

Fig 2

Fig 3

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MDS Abstracts - https://www.mdsabstracts.org/abstract/evaluating-environmental-cognitive-and-psychiatric-factors-in-pakistani-pd-patients-london-pakistan-parkinsons-project-lp-3-pilot-findings/