Objective: To investigate the association between symptoms of depression and symptoms of autonomic dysfunction (AuD) in people with Parkinson’s disease (PD).

Background: Depression and AuD are common and disabling non-motor symptoms of PD that portend a poor prognosis. Although the literature suggests an overlap in pathophysiology between these symptoms in PD, the examination of the relationship between these symptoms in clinical cohorts has remained rudimentary.

Method: Data were obtained from the Parkinson’s Progression Markers Initiative (PPMI), a prospective longitudinal database of early PD participants who are followed over several years with regular clinical evaluations, symptom assessments, and collection of neuroimaging and biospecimens. We compared associations of depression, AuD, and other demographic and clinical variables among PD and control participants at baseline and at visit 6 (24 months after initial, or baseline, study visit). Spearman correlation and Mann-Whitney-U tests were used to assess associations between variables, and regression modeling was used to measure predictors of AuD while controlling for potential confounding covariates.

Results: We show that symptoms of depression predict AuD in persons with PD but not in controls, and that this effect grows stronger with increasing disease duration. These findings are independent of severity of motor impairment, age, and use of depression or blood pressure medications.

Conclusion: These data build on the existing literature by supporting an overlapping pathophysiology between depression and AuD in PD. This finding accentuates the importance of identifying therapies for PD non-motor symptoms that can work synergistically with, rather than independently of, therapies for other PD symptoms.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/evidence-of-overlapping-pathology-between-depression-and-autonomic-dysfunction-in-parkinsons-disease/