Parkinson's Progression Marker Initiative (PPMI), United States of America

The Michael J. Fox Foundation PPMI/Institute for Neurodegenerative Disorders
https://www.ppmi-info.org/

Author Of 2 Presentations

NOVEL BIOMARKERS ACROSS THE PD CONTINUUM – PPMI 2.0

Session Type
SYMPOSIUM
Date
11.03.2021, Thursday
Session Time
10:00 - 12:00
Room
On Demand Symposia A
Lecture Time
11:45 - 12:00
Session Icon
On-Demand

Abstract

Abstract Body

The Parkinson Progression Marker Initiative (PPMI) is a longitudinal, observational, multi-center study to assess progression of clinical features, digital outcomes, and imaging, biologic and genetic markers of Parkinson’s disease (PD) progression. During the past ten years, the PPMI study has established a robust clinical and biomarker dataset. PPMI has now expanded to increase the number of participants across the PD continuum from prodromal to moderate PD and identify and explore the use of biomarkers to test hypotheses of the underlying molecular pathobiology of PD, enable modeling of PD progression to identify clinical and/or biologic data driven PD progression sub-sets, and inform studies testing PD therapeutics.

The expanded PPMI will will include the current PPMI cohorts plus approximately 1000 early PD and healthy participants and 2000 participants with Prodromal PD. The prodromal cohort will be enrolled based on a staged risk paradigm with initial assessment via PPMI online followed by DAT imaging to determine eligibility to participate in a five-year densely phenotypes longitudinal study.

We will present examples of PPMI data on that demonstrates the staged risk paradigm for prodromal PD and will provide exploratory data identifying clinical subsets of PD that may predict disease progression. PPMI will expand the existing data set and biorepository already available from PPMI. The PPMI expansion has the potential to establish a framework for developing a prodromal PD cohort and to identify meaningful clinical and biomarker outcomes that could accelerate clinical trials of both manifest and prodromal PD.

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MOTOR RESERVE AS A MODIFIER OF LONG-TERM PROGNOSIS IN PARKINSON’S DISEASE

Session Type
SYMPOSIUM
Date
14.03.2021, Sunday
Session Time
08:00 - 10:00
Room
On Demand Symposia A
Lecture Time
09:45 - 10:00
Session Icon
On-Demand

Abstract

Aims

In Alzheimer’s disease, higher cognitive reserve has been linked to a more rapid cognitive decline from the point of diagnosis. Whether similar trajectories exist concerning motor reserve (MR) in Parkinson's disease (PD) remains unclear. Here, we investigated the longitudinal decline in motor function by considering different levels of MR.

Methods

Data of 151 PD patients (Mage=58.7±4.5) were included, for whom a baseline DaT-SPECT and longitudinal clinical information were available at the PPMI database. Based on the residuals derived from the association between DaT signal loss and UPDRS-III score, we defined a group of high (n=50, Myears_follow-up=6.2) and low (n=45, Myears_follow-up=5.4) MR. To assess the trajectories of motor decline, we performed linear mixed-effects models with SPSS26 (p<.05), comparing the decline of high and low MR group over time. The model comprised an interaction term between time and reserve groups additionally to several covariates as fixed plus subjects and time as random effects, allowing individually varying slopes and intercepts. The model was corrected by an unstructured covariance matrix.

Results

At baseline, high MR was associated with significantly lower UPDRS-III scores compared to low MR. While this difference remained over 7 years (p=.029), no difference in group-average decline rate (p=.252) was observed. However, a positive covariance (covIntercept-Slope= .082, p=.018) between intercept and slope was found indicating that individual motor decline depends on baseline symptom severity.

Conclusions

Higher initial MR may be associated with slower disease progression and generally less severe symptoms over time, which has major implications for disease prognosis and the development of interventional strategies.

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