History of Traumatic Brain Injury Does Not Influence Rate of Progression of Clinical or Pathological Outcomes in Two Early Parkinson's Disease Cohorts

Background

A history of traumatic brain injury (TBI) is associated with an increased risk of developing neurodegenerative disorders, including Parkinson's Disease (PD). However, TBI's influences on disease progression remain underassessed. This study explored whether a history of TBI influences the progression of pathological and clinical outcomes up to 5 years of follow-up in individuals with early PD.

Methods

Longitudinal data were extracted from the Parkinson's Progression Markers Initiative (PPMI) and the PostCEPT observational study. Participants in PostCEPT had complete head injury data, while PPMI participants were eligible if they completed the head injury section of the PD Risk Factor Questionnaire (n = 208). Principal component analysis was used to derive composite scores of cognitive ability and mood dysfunction, with motor outcomes calculated using the Movement Disorders Society Unified Parkinson's Disease Rating Scale. Progression of clinical and pathological outcomes up to 5 years and 4 years following study entry were compared, including subset analyses in PPMI examining injury severity.

Results

Individuals with a history of TBI in the PPMI dataset exhibited a younger age of onset; however, a history of TBI did not affect progression rates of any assessed variables across both cohorts. Exploratory analysis determined that injury severity significantly predicted striatal dopamine transporter binding but accounted for only a small portion of outcome variance.

Conclusion

While the history of TBI was associated with earlier PD onset, it did not correspond to a differential disease course. However, given differences in TBI characterisation between cohorts, additional research must be conducted to validate these findings.