The impact of traumatic brain injury on cognitive and neuropsychiatric symptoms of Parkinson’s disease

Abstract

The objective was to determine whether a history of traumatic brain injury (TBI) was associated with Parkinson’s Disease (PD) and specific cognitive, motor, and neuropsychiatric symptoms. A cross-sectional cohort study of 120 participants aged 60–85 years old (48 females) were recruited (69 PD and 51 healthy controls). Assessments included demographic information, neuropsychological tests, a motor evaluation, neuropsychiatric questionnaires, and the Brain Injury Screening Questionnaire. A history of TBI or number of TBIs was not significantly related to an increased risk of developing PD or poorer motor scores on the United Parkinson Disease Rating Scale part 3. There was a significant negative correlation between number of TBI’s and mean z-scores of global cognition (r_s(69) = −0.338, p = 0.004), executive function (r_s(69) = −0.251, p = 0.038), memory (r_s(69) = −0.262, p = 0.029), and language (r_s(69) = −0.245, p = 0.042), and a significant positive correlation on the Beck Depression Inventory II (r_s(69) = 0.285, p = 0.018) and the Patient Health Questionnaire–9 (PHQ-9) (r_s(69) = 0.326, p = 0.006) in the PD group only. In conclusion, a history of TBI was negatively associated with cognition and positively associated with depressive symptoms in patients with PD, but not with motor symptoms.

Keywords:

• Parkinson’s disease
• traumatic brain injury
• mild cognitive impairment
• brain injury screening questionnaire

Acknowledgement

We would like to acknowledge Dr Wayne Gordon and his team at the Department of Rehabilitation Medicine in the Icahn School of Medicine at Mount Sinai for allowing us to use Part I of the BISQ. The study made use of the Calgary Parkinson Research Initiative registry at the Hotchkiss Brain Institute, University of Calgary://CaPRIresearch.org.

Documentation of authors roles

Julie Joyce aided in data analysis, statistics, writing the first draft of the manuscript and continual editing of the manuscript. Iris Kathol, Jenelle Cheetham, and Mekale Kibreab were instrumental in organization and execution of the research study. Drs Sarna and Marino contributed to the conceptualization and development of the research project as well as recruitment and editing of the manuscript. Dr Monchi contributed in all aspects of the project including project conception, organization, design, and execution of the project. He was instrumental in manuscript preparation and editing of the paper. Dr Ismail provided guidance in terms of clinical translation of psychiatric difficulties as well as reviewed and edited the manuscript. Finally, Dr Debert was involved in all aspect of the project. She initiated the conceptualization of the study and aided in the preparation and execution of the project. She was in statistical analysis, manuscript preparation, writing the first draft and further review, critique, and editing of the paper.

Disclosure statement

The authors report no conflict of interest.

Additional information

Funding

Julie Joyce was funded by the Branch out Neurological Foundation, Alberta Canada. Dr. Debert was funded by the Hotchkiss Brain Institute, University of Calgary, Cumming School of Medicine, Department of Clinical Neurosciences, University of Calgary, the Canadian Institute of Health Research, and the Department of Canadian National Defense. Dr. Monchi was funded by an operating grant from the Canadian Institutes of Health Research (MOP-126017), the Tourmaline Oil Chair in Parkinson’s Disease, The Canada Research Chair in non-motor symptoms of Parkinson’s disease, Brain Canada, Parkinson Canada and the Natural Sciences and Engineering Research Council of Canada. Dr. Martino has received research support from the Immunität und Seele foundation (Research Project Grant) and from Parkinson’s Association of Alberta (Fellowship supervision grant). Dr. Martino received royalties from Springer Verlag. Dr. Sarna received an Honoraria from Allergan, Abbvie, and Paladin. She is also involved in multi-center clinical trials funded by CHDI (non-profit), Brain Canada Foundation, and Abbvie. Iris Kathol, Jenelle Cheetham, and Mekale Kibreab have no disclosures. Dr. Zahinoor Ismail has received research funding from Brain Canada, Centre for Aging and Brain Health Innovation, Canadian Institutes of Health Research, and Janssen, and has received consulting fees/honoraria from Lundbeck, Otsuka, and Janssen.