npj Parkinsons Dis: New algorithm to help assess Parkinson's risk

Neurodegeneration prior to a formal diagnosis of Parkinson's disease (PD) is associated with recognizable motor and non-motor features

Neurodegeneration prior to a formal diagnosis of Parkinson's disease (PD) is associated with recognizable motor and non-motor features

Figure 1 Title map of the paper

Figure 1 Title map of the paper

Two notable risk estimation methods are the PREDICT-PD algorithm and the MDS precursor PD study criteria

Two notable risk estimation methods are the PREDICT-PD algorithm and the MDS precursor PD study criteria

The PREDICT-PD study was originally a prospective pilot study in people aged 60-80 years to estimate risk, including demographic information, environmental exposures, from information collected using simple online tests and remotely administered screening tools and early symptoms identified in systematic reviews and meta-analyses

The criteria for MDS prodromal PD studies first published in 2015 incorporated additional clinical and radiological testing, as well as these three markers

Risk estimates for PREDICT-PD were previously based on OR

To assess whether these steps improved risk estimates, they compared the risk distributions derived from the enhanced algorithm with those using the base PREDICT-PD algorithm and the MDS precursor standard algorithm

Finally, the relationship between risk estimates in a subgroup of participants previously reported using the underlying algorithm and subclinical striatal dopamine depletion as measured by dopamine transporter imaging (DaT-SPECT) was assessed

Figure 1 The new algorithm improves the accuracy of the PREDICT-PD prediction algorithm

Figure 1 The new algorithm improves the accuracy of the PREDICT-PD prediction algorithm

The enhanced PREDICT-PD algorithm produced a much larger range of risk estimates than the base algorithm (difference between the 10th and 90th percentiles was 93–609 times compared to 10–13 times)

The enhanced PREDICT-PD algorithm produced a much larger range of risk estimates than the base algorithm (difference between the 10th and 90th percentiles was 93–609 times compared to 10–13 times)

Compared with the base algorithm, the PD risk increased more with the enhanced algorithm as the risk score increased (hazard ratio per one standard deviation increase in log risk, 2.

The augmented algorithm estimates were also more strongly associated with subclinical striatal DaT-SPECT dopamine depletion (R2 = 0.

The significance of this study is the discovery that incorporating previous intermediate markers of prodromal PD and using likelihood ratios improved the accuracy of the PREDICT-PD prediction algorithm

Original source:
Bestwick JP, Auger SD, Simonet C, et al.
Improving estimation of Parkinson's disease risk—the enhanced PREDICT-PD algorithm.
npj Parkinsons Dis .
2021;7(1):33.
doi:10.
1038/s41531-021- 00176-9 Improving estimation of Parkinson's disease risk—the enhanced PREDICT-PD algorithm.
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