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Urate and homocysteine: predicting motor and cognitive changes in newly diagnosed Parkinson’s disease

Lookup NU author(s): Dr Isobel Sleeman, Dr Rachael LawsonORCiD, Professor Alison Yarnall, Dr Gordon Duncan, Dr Fionnuala Johnston, Dr Tien Kheng Khoo, Professor David Burn



This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0).


Background: Urate and homocysteine are potential biomarkers for disease progression in Parkinson’s disease (PD). Baseline serum urate concentration has been shown to predict motor but not cognitive decline. The relationship between serum homocysteine concentration and cognitive and motor impairment is unknown. Objectives: The aim of this study was to examine the association between baseline serum urate and homocysteine, and prospective measures of disease progression and cognition over 54 months in early PD.Methods: 154 newly diagnosed PD participants and 99 age-matched controls completed a schedule of assessments at baseline, 18, 36 and 54 months. The Movement Disorders Society Unified Parkinson’s Disease Scale Part III (MDS-UPDRS III) was used to assess motor severity. The Montreal Cognitive Assessment (MoCA) was used to assess global cognition. Serum samples drawn at baseline were analysed for urate, homocysteine, red cell folate and vitamin B12 concentrations.Results: Baseline urate was 331.4±83.8 and 302.7±78.0 µmol/L for control and PD participants, respectively (p=0.015). Baseline homocysteine was 9.6±3.3 and 11.1±3.8 µmol/L for controls and PD participants, respectively (p<0.01). Linear mixed effects modelling showed that lower baseline urate (β=0.02, p<0.001) and higher homocysteine (β=0.29, p<0.05) predicted decline in motor function. Only higher homocysteine concentrations at baseline, however, predicted declining MoCA scores over 54 months (β=0.11, p<0.01).Conclusions: Lower serum urate concentration is associated with worsening motor function; while higher homocysteine concentration is associated with change in motor function and cognitive decline. Therefore, urate and homocysteine may be suitable biomarkers for predicting motor and cognitive decline in early PD.

Publication metadata

Author(s): Sleeman I, Lawson RA, Yarnall AJ, Duncan GW, Johnston F, Khoo TK, Burn DJ

Publication type: Article

Publication status: Published

Journal: Journal of Parkinson's Disease

Year: 2019

Volume: 9

Issue: 2

Pages: 351-359

Online publication date: 23/05/2019

Acceptance date: 26/02/2019

Date deposited: 28/02/2019

ISSN (print): 1877-7171

ISSN (electronic): 1877-718X

Publisher: I O S Press


DOI: 10.3233/JPD-181535


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Funder referenceFunder name
J-0802Parkinson`s UK (formerly Parkinson`s Disease Society)