Moderating effects of uric acid and sex on cognition and psychiatric symptoms in asymmetric Parkinson’s disease

Abstract

Background Non-motor symptoms are an important early feature of Parkinson’s disease (PD), encompassing a variety of cognitive and psychiatric symptoms that seem to manifest differently depending on motor symptom asymmetry. Different factors, such as uric acid (UA) and sex, seem to influence cognitive and psychiatric expression in PD, however their interplay remains to be better understood. Methods Participants taking part in the Parkinson’s Progression Marker Initiative were studied based on the side of motor symptom asymmetry and sex. Three-way interaction modeling was used to examine the moderating effects of sex and UA on cognitive functions and psychiatric symptoms. Results Significant three-way interactions were highlighted at 1-year follow-up between motor symptom asymmetry, UA and sex for immediate and long-term memory in female patients exhibiting predominantly left-sided motor symptoms, and for processing speed and sleepiness in female patients exhibiting predominantly right-sided motor symptoms. No significant interactions were observed for male patients. Moreover, female patients exhibiting predominantly right-sided motor symptoms demonstrated lower serum UA concentrations and had overall better outcomes, while male patients with predominantly right-sided motor symptoms demonstrated particularly poor outcomes. Conclusions These findings suggest that in the earliest stages of the disease, UA and sex moderate cognitive functions and psychiatric symptoms differently depending on motor asymmetry, holding important clinical implications for symptom management in patients.

Uric Acid Inhibits Mice Pancreatic Steatosis via the Glycerophospholipid Pathway

“…The SUA level has a “J” shaped relationship with the risk of death associated with prostate cancer with the risk of death decreasing and then increasing as SUA levels rise. High levels of SUA are protective against neurological disorders, such as Parkinson’s disease, whereas low levels are harmful. − …”

“… 18 Moreover, at physiological concentrations, uric acid acts as an antioxidant, 19 − 23 scavenging oxygen radicals and exerting a protective effect on most organs, 19 , 22 except the nervous system. 22 Several studies have shown that low uric acid levels damage the nervous system, 24 , 25 whereas high uric acid levels exert protective effects. 26 Many studies have suggested that high-fat diets cause elevated uric acid levels in addition to elevated blood lipids.…”