Objective: To examine whether patients with Parkinson’s disease (PD) and a history of head trauma (HT) differ from those without HT in terms of motor and non-motor symptom profiles.

Background: HT has been suggested as a potential environmental risk factor for PD, but its influence on the clinical phenotype remains unclear.

Method: 237 patients with early PD (disease duration of up to five years and a modified Hoehn and Yahr[mHY] stage of 1–3) were enrolled. Motor and non-motor symptoms were assessed using standardised clinical scales. Motor subtypes were classified as tremor-dominant (TD), akinetic-rigid (AR) or mixed, according to established criteria. Clinical features were compared between patients with and without a self-reported history of HT.

Results: 35 patients (14.8%) reported HT. The HT group had a higher mHY stage than the non-HT group. Total tremor scores were lower in the HT group (1.71 ± 1.96 vs. 2.55 ± 2.27, p = 0.042; adjusted p = 0.024), as were rest tremor scores (0.94 ± 1.28 vs. 1.67 ± 1.77, p = 0.005; adjusted p = 0.010). The distribution of motor subtypes differed by HT status (p = 0.010; adjusted p = 0.015), with a lower frequency of the TD subtype (5.7% vs. 30.2%) and a higher frequency of the AR subtype (82.9% vs. 61.8%) observed in the HT group. Non-motor symptom burden did not differ between groups.

Conclusion: In early PD, a history of HT was associated with reduced tremor expression and a shift from the TD to the AR motor phenotype, with no clear differences in non-motor symptoms. These findings suggest that prior HT may influence the expression of motor phenotypes in PD.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/head-trauma-history-and-motor-phenotype-in-early-parkinsons-disease/