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Abstract Details

Environmental Exposure Speeds Symptom Progression in PD
Movement Disorders
P6 - Poster Session 6 (5:30 PM-6:30 PM)
5-005
The variability of symptom progression in people with PD (PwPD) is still largely unexplained. Specific environmental exposures have been associated with risk of PD and may predispose people to faster progression once disease develops.

To determine how environmental exposures prior to development of Parkinson’s disease (PD) relate to symptom progression in early disease.

PwPD in Fox Insight (FI) – an online, longitudinal study – reported various environmental exposures on the PD Risk Factor Questionnaire. We examined occupational pesticide exposure prior to PD diagnosis and head injury >5 years prior to PD diagnosis (HI). Severe HI was defined as HI complicated by fracture, seizure, or loss of consciousness. We limited analysis to PwPD who enrolled within two years of PD diagnosis and answered questionnaires at enrollment, 12 (±3) months, and 24 (±3) months.   We used Cox proportional hazard models to compare time from diagnosis to development of (a) the need for assistance with walking (according to the MDS-UPDRS II) and (b) self-reported cognitive impairment (a score of <49 on the Penn Daily Activities Questionnaire [PDAQ]) between PwPD with and without exposure, adjusting for enrollment age, sex, and education (for PDAQ). Data were censored at 27 months of follow up.
521 of 2,600 (20%) PwPD reported pesticide exposure before PD diagnosis.  1,065 of 3,278 (32%) reported HI >5 years before PD diagnosis. Pesticide exposure predicted faster progression to balance problems (aHR:2.29, 1.09–4.83, p=0.029) and to cognitive impairment (aHR:1.89, 1.05–3.41, p=0.034). Severe HI predicted faster progression to cognitive problems (aHR:1.93, 1.04–3.61, p=0.038). Exposure to both pesticides and HI was associated with faster progression of cognitive problems than either alone (aHR:2.57, 1.05-6.31, p=0.039).
Occupational pesticide exposure or HI prior to PD diagnosis may cause a faster progression of motor and cognitive symptoms once PD develops.
Authors/Disclosures
Ethan G. Brown, MD (University of California, San Francisco)
PRESENTER
Dr. Brown has received personal compensation in the range of $0-$499 for serving as a Consultant for Rune Labs, Inc. An immediate family member of Dr. Brown has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Novartis. An immediate family member of Dr. Brown has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. Dr. Brown has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for NEJM Knowledge Plus. The institution of Dr. Brown has received research support from Michael J. Fox Foundation. The institution of Dr. Brown has received research support from NIH.
Samuel Goldman, MD, MPH Dr. Goldman has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Littlepage Booth Leckman. The institution of Dr. Goldman has received research support from Michael J Fox Foundation. The institution of Dr. Goldman has received research support from US Department of Defense. The institution of Dr. Goldman has received research support from US Veterans Administration. The institution of Dr. Goldman has received research support from National Institutes of Health. The institution of Dr. Goldman has received research support from Health Resources and Services Administration. The institution of Dr. Goldman has received research support from American Academy of Pediatrics. Dr. Goldman has received personal compensation in the range of $100,000-$499,999 for serving as a Professor with University of California San Francisco. Dr. Goldman has received personal compensation in the range of $100,000-$499,999 for serving as a Staff Physician with San Francisco Veterans Affairs Health Care System.
Marta San Luciano, MD, FAAN (University of California San Francisco) Dr. San Luciano has received research support from NIH (NINDS).
Monica Korell, MPH Ms. Korell has nothing to disclose.
Caroline M. Tanner, MD, PhD, FAAN (University of California San Francisco, Weill Institute for Neurosciences) Dr. Tanner has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Evidera. Dr. Tanner has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Neurocrine. Dr. Tanner has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Jazz Pharmaceuticals/Cavion. Dr. Tanner has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Bial . Dr. Tanner has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Supernus. Dr. Tanner has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche Genentech. The institution of Dr. Tanner has received research support from Gateway LLC. The institution of Dr. Tanner has received research support from Roche\Genentech. The institution of Dr. Tanner has received research support from Michael J Fox Foundation . The institution of Dr. Tanner has received research support from National Institute of Health . The institution of Dr. Tanner has received research support from Department of Defense. Dr. Tanner has received personal compensation in the range of $500-$4,999 for serving as a Faculty, CME presentation with Medscape /WebND.