To investigate the predictive factors of cognitive and motor decline in Parkinson’s disease (PD)’s progression.

PD is a highly complex disease. Its progression is very heterogeneous among individuals making it hard to predict its individual trajectories. Factors correlated to cognitive and motor decline are being further investigated in order to discern the clinical phenotype based on baseline clinical characteristics.

A cross-sectional study was conducted in the Department of Neurology of Razi University Hospital including PD patients, diagnosed according to the movement disorder society (MDS) criteria of 2015. Personal history, demographic and clinical characteristics, electrophysiological study of the autonomic system and treatments were specified. To evaluate disease progression, data was assessed at baseline and during follow-up: Unified PD rating scale part III (UPDRS-III) and Hoehn and Yahr scale (HY) for motor decline estimation; Mini-Mental Status Examination (MMSE) for global cognitive performance evaluation and Frontal Assessment Battery (FAB) for evaluation of executive functions.

A total of 150 PD patients were included (sex-ratio=1.17; mean age= 66 years; Mean age of onset= 59.5 years; Mean disease duration = 7.4 years). At baseline, 42.1% were tremor dominant and 46% with postural instability/gait difficulty (PIGD) phenotype. No correlations were found for motor decline. Mean annual rate of cognitive decline of MMSE (0.48+2 points) was correlated to both clinical (including  orthostatic hypotension (p=0.015) and excessive sweating (p=0.015)) and elecrophysiological dysautonomia (parasympathetic function mainly to heart rate variability to deep breathing (p=0.028)  and sympathetic function ( p=0.008)).