Renin-angiotensin system blockers affect cognitive decline in Parkinson's disease: The PPMI dataset

Parkinsonism Relat Disord. 2022 Dec:105:90-95. doi: 10.1016/j.parkreldis.2022.10.019. Epub 2022 Oct 28.

Abstract

Objective: To explore the potential clinical effects of renin-angiotensin system blocker (RASB, angiotensin II receptor blockers (ARBs) and angiotensin-converting enzyme inhibitors (ACEIs)) in patients from the Parkinson's Progress Marker Initiative (PPMI) study database.

Methods: One hundred and seven untreated, newly diagnosed PD patients with hypertension, from the PPMI were included. We measured cognitive performance, biomarkers in CSF, and magnetic resonance imaging (MRI) during the five follow-up years for patients exposed or not to renal-angiotensin system blockers. Sixteen PD patients with hypertension underwent [18F]florbetaben positron emission tomography (PET) scanning. SUVRs of region of interest (ROI) were calculated and compared within different groups.

Result: Treatment with ARBs but not ACEIs improved global cognitive function evaluated by MoCA score in PD patients with hypertension compared to other hypertensive medicines up to 5 years follow up. Specifically, ARBs improved visuospatial, memory, executive abilities, processing speed attention test scores in PD. There was no significant impact of ARBs on α-syn, tau, Aβ in CSF. RASBs reduced [18F] florbetaben uptake in cortex and subcortex nuclei in the brain.

Conclusions: These results show potential protective effect with ARBs in cognitive impairment of parkinson's disease with hypertension.

Keywords: 18F florbetaben PET scan; Angiotensin converting enzyme inhibitors(ACEIs); Angiotensin receptor antagonists(ARBs); CSF biomarker; Cognition; Parkinson's disease; Renin-angiotensin system.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Angiotensin Receptor Antagonists / therapeutic use
  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use
  • Biomarkers
  • Cognitive Dysfunction* / diagnostic imaging
  • Cognitive Dysfunction* / drug therapy
  • Cognitive Dysfunction* / etiology
  • Humans
  • Hypertension* / complications
  • Hypertension* / diagnostic imaging
  • Hypertension* / drug therapy
  • Parkinson Disease* / complications
  • Parkinson Disease* / diagnostic imaging
  • Parkinson Disease* / drug therapy
  • Renin-Angiotensin System

Substances

  • 4-(N-methylamino)-4'-(2-(2-(2-fluoroethoxy)ethoxy)ethoxy)stilbene
  • Angiotensin Receptor Antagonists
  • Angiotensin-Converting Enzyme Inhibitors
  • Biomarkers