Clinical Non-Motor Phenotyping of Black and Asian Minority Ethnic Compared to White Individuals with Parkinson’s Disease Living in the United Kingdom

Article type: Research Article

Authors: Sauerbier, Anna^{a; b; c} | Schrag, Anette^d | Brown, Richard^{b; e} | Martinez-Martin, Pablo^f | Aarsland, Dag^{b; g} | Mulholland, Nicola^h | Vivian, Gill^h | Dafsari, Haidar S.^c | Rizos, Alexandra^a | Corcoran, Ben^h | Jarosz, Jozefⁱ | Siakallis, Loizosⁱ | Ray Chaudhuri, K.^{a; b; *}

Affiliations: [a] National Parkinson’s Centre of Excellence, King’s College Hospital, Denmark Hill, London, UK | [b] Department of Basic & Clinical Neurosciences, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, De Crespigny Park, London, UK | [c] Department of Neurology, University Hospital Cologne, Cologne, Germany | [d] Department of Clinical and Movement Neurosciences, UCL Institute of Neurology, University College London, London, UK | [e] South London and Maudsley NHS Foundation Trust, London, UK | [f] Center for Networked Biomedical Research in Neurodegenerative Diseases (CIBERNED), Carlos III Institute of Health, Madrid, Spain | [g] Department of Old Age Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK | [h] Department of Nuclear Medicine, King’s College Hospital, London, UK | [i] Department of Neuroradiology, King’s College Hospital, London, UK

Correspondence: [*] Correspondence to: K. Ray Chaudhuri, Department of Basic and Clinical Neuroscience, The Maurice Wohl Clinical Neuroscience Institute, King’s College London, Cutcombe Road, London SE5 9RT, UK. Tel.: +44 203 299 7153; E-mail: [email protected].

Abstract: Background:Ethnic phenotypic differences in Parkinson’s disease (PD) are important to understand the heterogeneity of PD and develop biomarkers and clinical trials. Objective:To investigate (i) whether there are non-motor symptoms (NMS)- and comorbidity-based phenotypic differences between Black, Asian and Minority Ethnic (BAME) and White PD patients and (ii) whether clinically available biomarkers may help differentiate and explain the differences between the groups. Methods:This is a multicentre (four sites, London), real-life, cross-sectional study including PD patients of BAME or White ethnicity. The primary outcome was a detailed NMS assessment; additional measurements included disease and motor stage, comorbidity, sociodemographic parameters and brain MRI imaging. Results:271 PD patients (54 Asian, 71 Black, and 146 White) were included balanced for age, gender, and disease severity (HY). Black patients had a shorter disease duration compared to White and Asian populations. The SCOPA-Motor activities of daily living scores as well as the NMSS scores were significantly higher in both Black (total score and domain “miscellaneous”) and Asian (total score and domains “sleep/fatigue”, “mood/apathy” and “perception/hallucinations”) than White individuals. Both BAME populations had higher prevalence of arterial hypertension, and the Black population had a higher prevalence of diabetes mellitus. Brain MRI revealed a greater severity of white matter changes in Black compared to the White and Asian cohorts. Conclusion:These findings suggest differences in phenotype of PD in BAME populations with greater burden of NMS and motor disability and a higher rate of cardiovascular comorbidities.

Keywords: Parkinson’s disease, ethnicity, BAME, non-motor symptoms

DOI: 10.3233/JPD-202218

Journal: Journal of Parkinson's Disease, vol. 11, no. 1, pp. 299-307, 2021