Early Parkinson’s Disease Phenotypes Tailored by Personality, Behavior, and Motor Symptoms

Article type: Research Article

Authors: Meira, Bruna^{a; b} | Lhommée, Eugénie^b | Schmitt, Emmanuelle^c | Klinger, Hélène^{d; e} | Bichon, Amélie^c | Pélissier, Pierre^b | Anheim, Mathieu^{f; g; h} | Tranchant, Christine^{f; g; h} | Fraix, Valérie^c | Meoni, Sara^c | Durif, Franckⁱ | Houeto, Jean-Luc^j | Azulay, Jean Philippe^k | Moro, Elena^c | Thobois, Stéphane^{d; e} | Krack, Paul^l | Castrioto, Anna^{c; *} | for the Honeymoon study group¹

Affiliations: [a] Neurology Department, Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal | [b] Movement Disorders Center, Neurology, CHU Grenoble Alpes, Grenoble, France | [c] Université Grenoble Alpes, Inserm, CHU Grenoble Alpes, Grenoble Institut Neurosciences, Grenoble, France | [d] Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer, Neurologie C, Centre Expert Parkinson, Lyon, France | [e] Univ Lyon, Université Claude Bernard Lyon 1, CNRS, Institut des Sciences Cognitives Marc Jeannerod, Bron, France | [f] Département de Neurologie, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg, Strasbourg, France | [g] Institut de Génétique et de Biologie Moléculaire et Cellulaire, (IGBMC), INSERM-U964/CNRS-UMR7104/, Université de Strasbourg, Illkirch, France | [h] Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg, France | [i] Université Clermont Auvergne, NPsy-Sydo, Clermont-Ferrand University Hospital, Neurology Department, Clermont-Ferrand, France | [j] Service de Neurologie, Centre Expert Parkinson, CHU de Limoges, UMR1094 INSERM, Université de Limoges, Limoges, France | [k] Neurology and Pathology Department of the Movement, University Hospital of Marseille, Timone Hospital, Marseille, France | [l] Department of Neurology, Inselspital, University Hospital Bern, Bern, Switzerland

Correspondence: [*] Corresponding to: Anna Castrioto, Movement Disorders Center, Neurology, CHU Grenoble Alpes, Grenoble, France. Tel.: +0033 04 76 76 9452; E-mail:[email protected].

Note: [1] A full list of members is located in the Supplementary Material.

Abstract: Background:Previous studies described a parkinsonian personality characterized as rigid, introverted, and cautious; however, little is known about personality traits in de novo Parkinson’s disease (PD) patients and their relationships with motor and neuropsychiatric symptoms. Objective:To investigate personality in de novo PD and explore its relationship with PD symptoms. Methods:Using Cloninger’s biosocial model, we assessed personality in 193 de novo PD patients. Motor and non-motor symptoms were measured using several validated scales. Cluster analysis was conducted to investigate the interrelationship of personality traits, motor, and non-motor symptoms. Results:PD patients showed low novelty seeking, high harm avoidance, and normal reward dependence and persistence scores. Harm avoidance was positively correlated with the severity of depression, anxiety, and apathy (rs = [0.435, 0.676], p < 0.001) and negatively correlated with quality of life (rs = –0.492, p < 0.001). Novelty seeking, reward dependence, and persistence were negatively correlated with apathy (rs = [–0.274, –0.375], p < 0.001). Classification of patients according to personality and PD symptoms revealed 3 distinct clusters: i) neuropsychiatric phenotype (with high harm avoidance and low novelty seeking, hypodopaminergic neuropsychiatric symptoms and higher impulsivity), ii) motor phenotype (with low novelty seeking and higher motor severity), iii) benign phenotype (with low harm avoidance and high novelty seeking, reward dependence, and persistence traits clustered with lower symptoms severity and low impulsivity). Conclusion:Personality in early PD patients allows us to recognize 3 patients’ phenotypes. Identification of such subgroups may help to better understand their natural history. Their longitudinal follow-up will allow confirming whether some personality features might influence disease evolution and treatment.

Keywords: Neuropsychiatric symptoms, non-motor symptoms, Parkinson’s disease, personality

DOI: 10.3233/JPD-213070

Journal: Journal of Parkinson's Disease, vol. 12, no. 5, pp. 1665-1676, 2022