Diabetes and Neuroaxonal Damage in Parkinson's Disease

Neurofilament Light: a biomarker of neurodegeneration correlated with Type 2 diabetes and other related diseases

“…After adjusting for age, BMI, hypertension, hypercholesterolaemia and history of stroke, diabetes remained significantly associated with higher serum NfL levels in patients with PD. Vijiaratnam et al [57] subsequently confirmed the finding of significantly higher serum NfL levels in patients with PD-DM in 280 patients with PD (29 with prevalent T2D). And regression analysis indicated that NfL levels in diabetic patients were significantly correlated with their disease status (correlation coefficient: 0.82, 95% confidence interval: 0.45-1, p<0.0001).…”

Reply to: “Diabetes and Neuroaxonal Damage in Parkinson's Disease”

“…We appreciate the letter by Vijiaratnam and colleagues, which confirms the association of diabetes with increased neuronal damage in patients with Parkinson's disease (PD) independent of age, body mass index, and vascular risk factors 1 . PD patients with diabetes revealed increased serum neurofilament light (sNfL) chain levels in both the biomarkers in Parkinson's disease (MARK‐PD) and Tracking Parkinson's Disease studies 1,2 .…”

“…We appreciate the letter by Vijiaratnam and colleagues, which confirms the association of diabetes with increased neuronal damage in patients with Parkinson's disease (PD) independent of age, body mass index, and vascular risk factors 1 . PD patients with diabetes revealed increased serum neurofilament light (sNfL) chain levels in both the biomarkers in Parkinson's disease (MARK‐PD) and Tracking Parkinson's Disease studies 1,2 . However, disease duration was much longer (12 years vs. 1 year), Hoehn & Yahr stage was more advanced (2.5 vs. 1.8), and Movement Disorder Society–Sponsored Revision of the Unified Parkinson's Disease Rating Scale III score was slightly higher (26 vs. 23) in the MARK‐PD study, whereas age and Montreal Cognitive Assessment scores were identical (ie, 68 years and 25 points, respectively) 1,2 .…”

“…PD patients with diabetes revealed increased serum neurofilament light (sNfL) chain levels in both the biomarkers in Parkinson's disease (MARK‐PD) and Tracking Parkinson's Disease studies 1,2 . However, disease duration was much longer (12 years vs. 1 year), Hoehn & Yahr stage was more advanced (2.5 vs. 1.8), and Movement Disorder Society–Sponsored Revision of the Unified Parkinson's Disease Rating Scale III score was slightly higher (26 vs. 23) in the MARK‐PD study, whereas age and Montreal Cognitive Assessment scores were identical (ie, 68 years and 25 points, respectively) 1,2 . Despite these differences, prevalent diabetes was associated with increased neuronal damage quantified by sNfL in early‐ and late PD underlining the robustness of this finding.…”

Type 2 Diabetes and Parkinson's Disease: A Focused Review of Current Concepts

“…46 In addition, survival from diagnosis was markedly reduced in a cohort of neuropathologically confirmed PD cases in whom T2D preceded the onset of motor symptoms. 47 Although vascular complications of T2D such as neuropathy and ischemic heart disease may exacerbate motor impairment in PD, biomarker studies have shown that PD patients with comorbid diabetes have higher serum neurofilament light chain levels independent of age, BMI, and other vascular risk factors, as well as lower striatal dopamine transporter binding and higher CSF tau levels, 41,48,49 suggesting that increased neuroaxonal damage is the substrate for faster PD progression in those with T2D.…”