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Abstract Details

Antibody Synthesis in the CNS is Associated with Cognition in Parkinson’s disease
Movement Disorders
P4 - Poster Session 4 (5:30 PM-6:30 PM)
3-010
To determine if elevated Immunoglobulin G (IgG) index, which measures antibody synthesis in the central nervous system, is associated with cognitive impairment in Parkinson’s disease (PD).
PD patients are at high risk of developing cognitive impairment and dementia. This could be because PD-associated neuronal death triggers a slow autoimmune process. Elevated IgG index may be a biomarker indicating this abnormal adaptive immune response.
We studied IgG index in 130 non-demented PD and 20 age-matched HC participants, and used MoCA to assess global cognitive impairment. IgG index <0.65 was considered normal. We performed univariate and multivariate linear regression analyses, which included IgG index, age, gender, education, and disease duration, to determine if high IgG index predicts cognitive impairment in PD.

We found significantly higher IgG index in PD (median[IQR]: 0.63 [0.48-0.94]) compared to HC (0.43 [0.33-0.57]), (p<0.001). Sixty-nine PD had normal IgG index (0.48 [0.38-0.57]) and 61 PD had a high IgG index (0.95 [0.77-1.21]). In non-demented PD, IgG index was significantly associated with lower MoCA. Specifically, the unadjusted linear regression model showed that IgG index predicts lower MoCA (beta[standard error]; -1.223 [0.511], p<0.05). In the fully-adjusted model, which included all four clinical measures as covariates, IgG index, age, and gender were significant predictors of lower MoCA.

In an exploratory analysis, IgG index was significantly associated with motor impairment (MDS-UPDRS-III, ON-Medication) in the unadjusted model (4.942[2.201], p<0.05). In the fully-adjusted model, neither IgG index nor any clinical covariates predicted motor impairment.

IgG index is elevated in PD and may contribute to cognitive and motor impairment. This is consistent with the hypothesis that PD-associated neuronal death triggers a slow autoimmune process. IgG index may be a promising biomarker for clinical trials, and treatment with autoimmune medications may mitigate cognitive impairment in PD patients with elevated IgG index.
Authors/Disclosures
Marian Shahid (Stanford University)
PRESENTER 		No disclosure on file
Patricia Linortner, PhD (Stanford University) No disclosure on file
Li Zhu Li Zhu has received personal compensation for serving as an employee of Biogen.
Cyrus P. Zabetian, MD (VA Puget Sound Health Care System) The institution of Dr. Zabetian has received research support from American Parkinson Disease Association. The institution of Dr. Zabetian has received research support from Department of Veterans Affairs. The institution of Dr. Zabetian has received research support from NIH. Dr. Zabetian has a non-compensated relationship as a Member, Scientific Advisory Council with Lewy Body Dementia Association that is relevant to Â鶹´«Ã½Ó³»­ interests or activities.
Joseph F. Quinn, MD, FÂ鶹´«Ã½Ó³»­ (OHSU Neurology) Dr. Quinn has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Retrophin. Dr. Quinn has received personal compensation in the range of $500-$4,999 for serving as a DSMB with Alzheimer's Disease Cooperative Study. Dr. Quinn has received personal compensation in the range of $500-$4,999 for serving as a DSMB with Alzheimer's Therapeutic Research Institute. Dr. Quinn has a non-compensated relationship as a consultant with Cognition Therapeutics that is relevant to Â鶹´«Ã½Ó³»­ interests or activities.
No disclosure on file
Thomas J. Montine, MD, PhD Dr. Montine has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Enable Medicine. Dr. Montine has stock in Enable Medicine. The institution of Dr. Montine has received research support from NIH. The institution of Dr. Montine has received research support from MJFF. Dr. Montine has received intellectual property interests from a discovery or technology relating to health care. Dr. Montine has received publishing royalties from a publication relating to health care.
No disclosure on file
Marion S. Buckwalter, MD, PhD (Stanford School of Medicine) No disclosure on file
Kathleen Poston, MD, FÂ鶹´«Ã½Ó³»­ (Stanford University) Dr. Poston has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Curasen Therapeutics, INC. Dr. Poston has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Amprion, INC. Dr. Poston has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for NIH. Dr. Poston has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Movement Disorders Journal. Dr. Poston has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Annals of Neurology. Dr. Poston has stock in Curasen Therapeutics, INC. Dr. Poston has stock in Amprion, INC. The institution of Dr. Poston has received research support from NIH. The institution of Dr. Poston has received research support from Michael J Fox Foundation. The institution of Dr. Poston has received research support from Alzheimer's Drug Discovery Foundation . The institution of Dr. Poston has received research support from Lewy Body Dementia Association. Dr. Poston has received intellectual property interests from a discovery or technology relating to health care.