Evidence map›Paper›PMID 37080759›Full record

ArticleJournal of neurology, neurosurgery, and psychiatry2023

Visual dysfunction is a better predictor than retinal thickness for dementia in Parkinson's disease.

Naomi Hannaway, Angeliki Zarkali, Louise-Ann Leyland, Fion Bremner, Jennifer M Nicholas, Siegfried K Wagner, Matthew Roig, Pearse A Keane, Ahmed Toosy, Jeremy Chataway and 1 more

Registry-linked trialOpen access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of neurology, neurosurgery, and psychiatry, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06193421 (An Open-Label Pilot Study for Assessing the Safety and Efficacy of High-Dose Ambroxol), which is not on this map. Cited by 20 papers.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed
6.2field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06193421 phase1 / phase2unknown statusnot on this map

An Open-Label Pilot Study for Assessing the Safety and Efficacy of High-Dose Ambroxol (HDA) in Newly Diagnosed GBA1 Parkinson Disease (PD)

TypeinterventionalSponsorAgyany Pharma LTDRan2023 to 2025Enrolled40ConditionsParkinson Disease, GBA Gene MutationArmsAmbroxol Hydrochloride
3 · Its place in the literature

Who cites it

20 citing papers in PubMed, 30 citations in OpenAlex.

  1. Gray Matter Microstructure Measured Using Diffusion Imaging as a Biomarker of Severity in Lewy Body Diseases.Movement disorders : official journal of the Movement Disorder Society · 2026
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  5. Review
  6. Cortical and subcortical morphological alterations inFrontiers in aging neuroscience · 2026
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  7. Article
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  10. Neuroimaging and plasma biomarker differences and commonalities in Lewy body dementia subtypes.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2025
    Article
  11. Dynamics of retinal changes in early-stage Parkinson's disease.Acta neuropathologica communications · 2025
    Article
  12. Article
  13. Review
  14. Article
  15. Review
  16. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 7 institutions in 1 country.

Naomi HannawayDementia Research Centre, Institute of Neurology, University College London, London, UK.ORCID 0000-0001-8608-7757
Angeliki ZarkaliDementia Research Centre, Institute of Neurology, University College London, London, UK.
Louise-Ann LeylandDementia Research Centre, Institute of Neurology, University College London, London, UK.
Fion BremnerNational Hospital for Neurology and Neurosurgery, University College London Hospitals, London, UK.
Jennifer M NicholasDementia Research Centre, Institute of Neurology, University College London, London, UK.
Siegfried K WagnerMoorfields Eye Hospital, London, UK.
Matthew RoigUCL Queen Square Institute of Neurology, London, UK.
Pearse A KeaneUCL Queen Square Institute of Neurology, London, UK.
Ahmed ToosyQueen Square Multiple Sclerosis Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, University College London, London, UK.
Jeremy ChatawayQueen Square Multiple Sclerosis Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, University College London, London, UK.
Rimona Sharon WeilDementia Research Centre, Institute of Neurology, University College London, London, UK r.weil@ucl.ac.uk.ORCID 0000-0002-5092-6325
UK Dementia Research Institute · GBNational Hospital for Neurology and Neurosurgery · GBQueen Mary University of London · GBLondon School of Hygiene & Tropical Medicine · GBMoorfields Eye Hospital · GBRoyal London Hospital · GBWellcome Centre for Human Neuroimaging · GB

Funding

Department of Health 541/CAP/OC/818837Medical Research Council MR/S026088/1Medical Research Council MR/T019050/1Medical Research Council MR/TR000953/1Wellcome Trust 205167/Z/16/Z
6 · The paper itself

Abstract

backgroundDementia is a common and devastating symptom of Parkinson's disease (PD). Visual function and retinal structure are both emerging as potentially predictive for dementia in Parkinson's but lack longitudinal evidence.

methodsWe prospectively examined higher order vision (skew tolerance and biological motion) and retinal thickness (spectral domain optical coherence tomography) in 100 people with PD and 29 controls, with longitudinal cognitive assessments at baseline, 18 months and 36 months. We examined whether visual and retinal baseline measures predicted longitudinal cognitive scores using linear mixed effects models and whether they predicted onset of dementia, death and frailty using time-to-outcome methods.

resultsPatients with PD with poorer baseline visual performance scored lower on a composite cognitive score (β=0.178, SE=0.05, p=0.0005) and showed greater decreases in cognition over time (β=0.024, SE=0.001, p=0.013). Poorer visual performance also predicted greater probability of dementia (χ² (1)=5.2, p=0.022) and poor outcomes (χ² (1) =10.0, p=0.002). Baseline retinal thickness of the ganglion cell-inner plexiform layer did not predict cognitive scores or change in cognition with time in PD (β=-0.013, SE=0.080, p=0.87; β=0.024, SE=0.001, p=0.12).

conclusionsIn our deeply phenotyped longitudinal cohort, visual dysfunction predicted dementia and poor outcomes in PD. Conversely, retinal thickness had less power to predict dementia. This supports mechanistic models for Parkinson's dementia progression with onset in cortical structures and shows potential for visual tests to enable stratification for clinical trials.

Indexed as

Cognitive DysfunctionDementiaParkinson DiseaseHumansRetinaVision DisorderscognitiondementiaParkinson's diseasevision

Identifiers

PMID37080759
PMCPMC10447370
OpenAlexW4366598105

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.