Hubungan antara Kadar Malondialdehid dengan Tingkat Keparahan Gejala Motorik dan Fungsi Kognitif Pasien Penyakit Parkinson

Abstract

Background: Oxidative stress is suspected to play a role in the pathogenesis of Parkinson’s disease (PD) through the production of reactive oxygen species (ROS), which can lead to the loss of dopaminergic neurons. Post-mortem studies of PD patients' brains have shown increased oxidative activity. Malondialdehyde (MDA) is a widely accepted biomarker of oxidative stress, reflecting tissue damage through lipid peroxidation. Elevated MDA levels have been associated with pathological and degenerative changes in the brain. However, its relationship with motor symptom severity and cognitive function in PD remains insufficiently explored.

Purpose: To investigate the relationship between MDA levels and the severity of motor symptoms and cognitive function in patients with Parkinson’s disease.

Methods: This cross-sectional study involved 35 patients with Parkinson’s disease who received treatment at the Neurology Clinic of Adam Malik General Hospital and USU Hospital. Serum MDA levels were measured using the TBARS (Thiobarbituric Acid Reactive Substances) method. Motor symptom severity was assessed using the Unified Parkinson’s Disease Rating Scale (UPDRS) part III. Cognitive function was evaluated using the Montreal Cognitive Assessment – Indonesian version (MoCA-Ina), Trail Making Test A (TMTA), and Trail Making Test B (TMTB).

Results: A significant positive correlation was observed between malondialdehyde (MDA) levels and the severity of motor symptoms (r = 0.421; p = 0.012). Post-hoc analysis revealed significant differences in MDA levels between the mild and moderate groups (p = 0.032), as well as between the mild and severe groups (p = 0.022), but not between the moderate and severe groups (p = 0.421). No significant correlation was found between MDA levels and MoCA-Ina scores or performance on the TMTA (r = 0.206, p = 0.235; r = 0.079, p = 0.684). However, patients with abnormal TMTB performance exhibited higher MDA levels in contrast to participants who obtained normal results (p = 0.043).

Conclusion: MDA is correlated with motor symptom severity and executive dysfunction in PD.