LAUSR

PD will likely become 2 to 3 times as common as it is now during the next 2 decades. Aging of the population is the FIG. 1. Plasma TMAO levels in controls and patients with PD with variable disease severity and progression. (A) Plasma TMAO levels were higher in patients with PD than in controls (6.84 0.73 vs 3.76 0.38 μM; P = 0.002). (B) Mean plasma TMAO levels were significantly elevated in patients with advanced-stage PD compared with those with early-stage disease (7.85 1.24 vs 5.87 0.76 μM; P = 0.014). (C) Mean plasma TMAO levels did not differ significantly between patients with PD with normal cognition and those with PD with dementia (6.33 0.56 vs 10.61 4.53 μM; P = 0.22). TMAO levels were higher in patients with PD with normal cognition than in healthy controls (6.33 0.56 vs 3.76 0.38 μM; P = 0.02). Kaplan-Meier plots show outcomes for (D) motor progression and (E) cognition progression in patients with PD who had baseline TMAO concentrations at/above or below the cutoff levels determined in receiver operating characteristic analyses. NC, normal cognition; PD, Parkinson’s disease; PDD, Parkinson’s disease with dementia; TMAO, trimethylamine N-oxide. *P < 0.05; **P < 0.01. [Color figure can be viewed at wileyonlinelibrary.com]