Prevalence and duration of non-motor symptoms in prodromal Parkinson's disease.


Journal

European journal of neurology
ISSN: 1468-1331
Titre abrégé: Eur J Neurol
Pays: England
ID NLM: 9506311

Informations de publication

Date de publication:
07 2019
Historique:
received: 01 06 2018
accepted: 22 01 2019
pubmed: 2 2 2019
medline: 28 7 2020
entrez: 2 2 2019
Statut: ppublish

Résumé

The prevalence and duration of non-motor symptoms (NMS) in prodromal Parkinson's disease (PD) has not been extensively studied. The aim of this study was to determine the prevalence and duration of prodromal NMS (pNMS) in a cohort of patients with recently diagnosed PD. We evaluated the prevalence and duration of pNMS in patients with early PD (n = 154). NMS were screened for using the Non-Motor Symptom Questionnaire (NMSQuest). We subtracted the duration of the presence of each individual NMS reported from the duration of the earliest motor symptom. NMS whose duration preceded the duration of motor symptoms were considered a pNMS. Individual pNMS were then grouped into relevant pNMS clusters based on the NMSQuest domains. Motor subtypes were defined as tremor dominant, postural instability gait difficulty (PIGD) and indeterminate type according to the Movement Disorder Society Unified Parkinson's Disease Rating Scale revision. Prodromal NMS were experienced by 90.3% of patients with PD and the median number experienced was 4 (interquartile range, 2-7). A gender difference existed in the pNMS experienced, with males reporting more sexual dysfunction, forgetfulness and dream re-enactment, whereas females reported more unexplained weight change and anxiety. There was a significant association between any prodromal gastrointestinal symptoms [odds ratio (OR), 2.30; 95% confidence interval (CI), 1.08-4.89, P = 0.03] and urinary symptoms (OR, 2.54; 95% CI, 1.19-5.35, P = 0.016) and the PIGD phenotype. Further analysis revealed that total pNMS were not significantly associated with the PIGD phenotype (OR, 1.10; 95% CI, 0.99-1.21, P = 0.068). Prodromal NMS are common and a gender difference in pNMS experienced in prodromal PD may exist. The PIGD phenotype had a higher prevalence of prodromal gastrointestinal and urinary tract symptoms.

Sections du résumé

BACKGROUND AND PURPOSE
The prevalence and duration of non-motor symptoms (NMS) in prodromal Parkinson's disease (PD) has not been extensively studied. The aim of this study was to determine the prevalence and duration of prodromal NMS (pNMS) in a cohort of patients with recently diagnosed PD.
METHODS
We evaluated the prevalence and duration of pNMS in patients with early PD (n = 154). NMS were screened for using the Non-Motor Symptom Questionnaire (NMSQuest). We subtracted the duration of the presence of each individual NMS reported from the duration of the earliest motor symptom. NMS whose duration preceded the duration of motor symptoms were considered a pNMS. Individual pNMS were then grouped into relevant pNMS clusters based on the NMSQuest domains. Motor subtypes were defined as tremor dominant, postural instability gait difficulty (PIGD) and indeterminate type according to the Movement Disorder Society Unified Parkinson's Disease Rating Scale revision.
RESULTS
Prodromal NMS were experienced by 90.3% of patients with PD and the median number experienced was 4 (interquartile range, 2-7). A gender difference existed in the pNMS experienced, with males reporting more sexual dysfunction, forgetfulness and dream re-enactment, whereas females reported more unexplained weight change and anxiety. There was a significant association between any prodromal gastrointestinal symptoms [odds ratio (OR), 2.30; 95% confidence interval (CI), 1.08-4.89, P = 0.03] and urinary symptoms (OR, 2.54; 95% CI, 1.19-5.35, P = 0.016) and the PIGD phenotype. Further analysis revealed that total pNMS were not significantly associated with the PIGD phenotype (OR, 1.10; 95% CI, 0.99-1.21, P = 0.068).
CONCLUSIONS
Prodromal NMS are common and a gender difference in pNMS experienced in prodromal PD may exist. The PIGD phenotype had a higher prevalence of prodromal gastrointestinal and urinary tract symptoms.

Identifiants

pubmed: 30706593
doi: 10.1111/ene.13919
pmc: PMC6563450
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

979-985

Subventions

Organisme : Parkinson's UK
ID : J-0802
Pays : United Kingdom

Informations de copyright

© 2019 The Authors. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.

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Auteurs

R Durcan (R)

Institute of Neuroscience, Newcastle University, Newcastle Upon Tyne, UK.

L Wiblin (L)

Institute of Neuroscience, Newcastle University, Newcastle Upon Tyne, UK.

R A Lawson (RA)

Institute of Neuroscience, Newcastle University, Newcastle Upon Tyne, UK.

T K Khoo (TK)

School of Medicine and Menzies Health Institute Queensland, Griffith University, Nathan, QLD, Australia.
School of Medicine, University of Wollongong, Wollongong, NSW, Australia.

A J Yarnall (AJ)

Institute of Neuroscience, Newcastle University, Newcastle Upon Tyne, UK.

G W Duncan (GW)

Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.

D J Brooks (DJ)

Institute of Neuroscience, Newcastle University, Newcastle Upon Tyne, UK.
Department of Nuclear Medicine and PET Centre, Aarhus University Hospital, Aarhus, Denmark.

N Pavese (N)

Institute of Neuroscience, Newcastle University, Newcastle Upon Tyne, UK.
Department of Nuclear Medicine and PET Centre, Aarhus University Hospital, Aarhus, Denmark.

D J Burn (DJ)

Faculty of Medical Science, Newcastle University, Newcastle Upon Tyne, UK.

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