In the world of Parkinson’s disease, low skull bone density may sound like an unrelated concern. But research has shown that poor skull bone density in women with PD is actually associated with a worse motor prognosis. It’s like having a weaker foundation for a building, making it more difficult to support the body’s movements. Just as brittle bones can lead to fractures in osteoporosis, low skull bone density may indicate an underlying vulnerability in the brain’s motor system. This study analyzed the data of female PD patients and found that lower skull bone density was linked to lower baseline dopamine availability, an increased risk of levodopa-induced dyskinesia (LID) and wearing-off, and a steeper increase in the dose of levodopa during follow-up. This suggests that skull bone density could serve as a potential indicator of motor prognosis in women with PD. To delve deeper into this fascinating connection between bones and brains, check out the underlying research!

Parkinson’s disease (PD) and osteoporosis are degenerative diseases that have shared pathomechanisms. To investigate the associations of skull bone density with nigrostriatal dopaminergic degeneration and longitudinal motor prognosis in female patients with PD. We analyzed the data of 260 drug-naïve female PD patients aged ≥50 years old who were followed-up for ≥3 years after their first visit to the clinic with baseline dopamine transporter (DAT) imaging. We measured skull bone density as a surrogate marker for systemic bone loss by calculating the Hounsfield unit (HU) in computed tomography scans. A Cox proportional hazard model was built to compare the rates of levodopa-induced dyskinesia (LID) or wearing-off according to skull HU. Longitudinal changes in levodopa-equivalent dose (LED) during a 3-year follow-up were assessed using a linear mixed model. A lower skull HU was associated with lower baseline DAT availability in striatal subregions; however, this relationship was not significant after adjusting for age, disease duration, body mass index, and white matter hyperintensities. After adjusting for confounding factors, a lower skull HU was significantly associated with an increased risk of LID development (hazard ratio = 1.660 per 1 standard deviation decrease, p = 0.007) and wearing-off (hazard ratio = 1.613, p = 0.016) in younger (<67 years) but not in older patients. Furthermore, a lower skull HU was associated with a steeper increase in LED during follow-up in younger patients only (β = –21.99, p < 0.001). This study suggests that baseline skull bone density would be closely linked to motor prognosis in drug naïve women with PD.

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