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Abstract
With the growing awareness of the presence of non-motor symptoms in Parkinson's disease (PD) has come the realization that these non-motor features play a tremendously important, and sometimes dominant, role in the management and even the diagnosis of the disorder. Despite this, a reluctance to formally address and treat the non-motor symptoms of PD remains and quality of life for PD patients suffers. This review provides an overview of the impact non-motor symptoms have on persons with PD, along with a brief description of some of the more common non-motor features of PD.
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Antonini A, Bauer L, Dohin E, Oertel WH, Rascol O, Reichmann H, Schmid M, Singh P, Tolosa E, Chaudhuri KR. Effects of rotigotine transdermal patch in patients with Parkinson's disease presenting with non-motor symptoms - results of a double-blind, randomized, placebo-controlled trial. Eur J Neurol 2015; 22:1400-7. [DOI: 10.1111/ene.12757] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Accepted: 04/27/2015] [Indexed: 12/25/2022]
Affiliation(s)
- A. Antonini
- Parkinson and Movement Disorders Unit; IRCCS Hospital San Camillo; Venice Italy
| | - L. Bauer
- UCB Pharma; Monheim am Rhein Germany
| | | | - W. H. Oertel
- Department of Neurology; Philipps University; Marburg Germany
| | - O. Rascol
- Clinical Investigation Centre CIC1436; and Departments of Clinical Pharmacology and Neurosciences; INSERM and Toulouse University Hospital; Toulouse France
| | - H. Reichmann
- Department of Neurology; University of Dresden; Dresden Germany
| | - M. Schmid
- UCB Pharma; Monheim am Rhein Germany
| | - P. Singh
- UCB Pharma; Monheim am Rhein Germany
| | - E. Tolosa
- Neurology Service; Hospital Clinic de Barcelona; Universitat de Barcelona; IDIBAPS; Centro de Investigacion Biomedica en Red sobre Enfermedades Neurodegenerativas (CIBERNED); Barcelona Catalonia Spain
| | - K. Ray Chaudhuri
- National Parkinson Foundation International Centre of Excellence; King's College Hospital; Kings College and Kings Health Partners; London UK
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Liu R, Umbach DM, Peddada SD, Xu Z, Tröster AI, Huang X, Chen H. Potential sex differences in nonmotor symptoms in early drug-naive Parkinson disease. Neurology 2015; 84:2107-15. [PMID: 25925983 DOI: 10.1212/wnl.0000000000001609] [Citation(s) in RCA: 77] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Accepted: 01/06/2015] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To examine potential sex differences in nonmotor symptoms (NMS) among drug-naive patients with Parkinson disease (PD), and to identify NMS that can best differentiate patients with early PD from controls. METHODS Our cross-sectional analysis included 414 newly diagnosed, untreated patients with PD (269 men and 145 women) and 188 healthy controls (121 men and 67 women) in the Parkinson's Progression Markers Initiative Study. NMS were measured using well-validated instruments covering sleep, olfactory, neurobehavioral, autonomic, and neuropsychological domains. RESULTS Male and female patients with PD were fairly comparable on motor presentations but differed on several nonmotor features. Male patients with PD had significantly more pronounced deficits in olfaction (p = 0.02) and in certain cognitive measurements (all p < 0.01) than female patients, whereas female cases experienced higher trait anxiety (p = 0.02). Multiple stepwise logistic regression analysis showed that the combination of NMS measures-University of Pennsylvania Smell Identification Test (UPSIT), Montreal Cognitive Assessment (MoCA), Scales for Outcomes in Parkinson's Disease-Autonomic (SCOPA-AUT), and state anxiety from the State-Trait Anxiety Inventory-effectively differentiated patients with PD from controls with an area under the receiver operating characteristic curve (AUC) of 0.913 (95% confidence interval [CI]: 0.89-0.94). UPSIT, MoCA, and SCOPA-AUT were the most predictive NMS measurements in men (AUC = 0.919; 95% CI: 0.89-0.95) as compared to UPSIT, MoCA, and REM Sleep Behavior Disorder Screening Questionnaire in women (AUC = 0.903; 95% CI: 0.86-0.95). CONCLUSIONS Our analysis revealed notable sex differences in several nonmotor features of patients with de novo PD. Furthermore, we found a parsimonious NMS combination that could effectively differentiate de novo cases from healthy controls.
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Affiliation(s)
- Rui Liu
- From the Epidemiology Branch (R.L., Z.X., H.C.) and Biostatistics and Computational Biology Branch (D.M.U., S.D.P.) of the National Institute of Environmental Health Sciences, Research Triangle Park, NC; Barrow Neurological Institute (A.I.T.), Phoenix, AZ; Department of Neurology (X.H.), Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA.
| | - David M Umbach
- From the Epidemiology Branch (R.L., Z.X., H.C.) and Biostatistics and Computational Biology Branch (D.M.U., S.D.P.) of the National Institute of Environmental Health Sciences, Research Triangle Park, NC; Barrow Neurological Institute (A.I.T.), Phoenix, AZ; Department of Neurology (X.H.), Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA
| | - Shyamal D Peddada
- From the Epidemiology Branch (R.L., Z.X., H.C.) and Biostatistics and Computational Biology Branch (D.M.U., S.D.P.) of the National Institute of Environmental Health Sciences, Research Triangle Park, NC; Barrow Neurological Institute (A.I.T.), Phoenix, AZ; Department of Neurology (X.H.), Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA
| | - Zongli Xu
- From the Epidemiology Branch (R.L., Z.X., H.C.) and Biostatistics and Computational Biology Branch (D.M.U., S.D.P.) of the National Institute of Environmental Health Sciences, Research Triangle Park, NC; Barrow Neurological Institute (A.I.T.), Phoenix, AZ; Department of Neurology (X.H.), Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA
| | - Alexander I Tröster
- From the Epidemiology Branch (R.L., Z.X., H.C.) and Biostatistics and Computational Biology Branch (D.M.U., S.D.P.) of the National Institute of Environmental Health Sciences, Research Triangle Park, NC; Barrow Neurological Institute (A.I.T.), Phoenix, AZ; Department of Neurology (X.H.), Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA
| | - Xuemei Huang
- From the Epidemiology Branch (R.L., Z.X., H.C.) and Biostatistics and Computational Biology Branch (D.M.U., S.D.P.) of the National Institute of Environmental Health Sciences, Research Triangle Park, NC; Barrow Neurological Institute (A.I.T.), Phoenix, AZ; Department of Neurology (X.H.), Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA
| | - Honglei Chen
- From the Epidemiology Branch (R.L., Z.X., H.C.) and Biostatistics and Computational Biology Branch (D.M.U., S.D.P.) of the National Institute of Environmental Health Sciences, Research Triangle Park, NC; Barrow Neurological Institute (A.I.T.), Phoenix, AZ; Department of Neurology (X.H.), Pennsylvania State University-Milton S. Hershey Medical Center, Hershey, PA
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Silva Lopes MD, Souza Melo AD, Nóbrega AC. Delayed latencies of auditory evoked potential P300 are associated with the severity of Parkinson's disease in older patients. ARQUIVOS DE NEURO-PSIQUIATRIA 2014; 72:296-300. [PMID: 24760094 DOI: 10.1590/0004-282x20140005] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Accepted: 01/07/2014] [Indexed: 11/21/2022]
Abstract
UNLABELLED Electrophysiological methods could provide important information about the neurophysiological status in Parkinson's disease (PD). OBJECTIVE To investigate the prolonged auditory P300 latency in PD and its association with the disease clinical stage. METHOD Clinical profiles of 44 patients were evaluated and those in initial and advanced stages of PD were identified. The frequency of altered latencies, median of latencies in each stage, and correlation between latencies and motor and non-motor clinical features were analyzed. Latencies were considered altered when they were more than two standard deviations from the mean of controls, per age group. RESULTS It was verified 10% of alterations in initial stages and 31% in advanced. There was correlation between latencies and non-motor clinical features. Subjects older than 65, in advanced stages, presented a significant increase of latencies. CONCLUSION There was an association between PD severity and P300 prolonged latencies among subjects 65 years old or older.
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Affiliation(s)
- Marcia da Silva Lopes
- Divisão de Neurologia e Epidemiologia, Universidade Federal da Bahia, Salvador, BA, Brazil
| | - Ailton de Souza Melo
- Divisão de Neurologia e Epidemiologia, Universidade Federal da Bahia, Salvador, BA, Brazil
| | - Ana Caline Nóbrega
- Departamento de Fonoaudiologia, Instituto de Ciências da Saúde, Universidade Federal da Bahia, Salvador, BA, Brazil
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Weerkamp NJ, Tissingh G, Poels PJ, Zuidema SU, Munneke M, Koopmans RT, Bloem BR. Nonmotor Symptoms in Nursing Home Residents with Parkinson's Disease: Prevalence and Effect on Quality of Life. J Am Geriatr Soc 2013; 61:1714-21. [DOI: 10.1111/jgs.12458] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Nico J. Weerkamp
- Department of Neurology; Atrium Medical Center; Heerlen the Netherlands
- Department of Neurology; Nijmegen Center for Evidence Based Practice; Radboud University Nijmegen Medical Center; Nijmegen the Netherlands
| | - Gerrit Tissingh
- Department of Neurology; Atrium Medical Center; Heerlen the Netherlands
| | - Petra J.E. Poels
- Department of Neurology; Nijmegen Center for Evidence Based Practice; Radboud University Nijmegen Medical Center; Nijmegen the Netherlands
| | - Systse U. Zuidema
- Department of General Practice; University of Groningen; University Medical Center Groningen; Groningen the Netherlands
| | - Marten Munneke
- Department of Neurology; Nijmegen Center for Evidence Based Practice; Radboud University Nijmegen Medical Center; Nijmegen the Netherlands
| | - Raymond T.C.M. Koopmans
- Department of Primary and Community Care; Center for Family Medicine, Geriatric Care and Public Health; Radboud University Nijmegen Medical Center; Nijmegen the Netherlands
| | - Bastiaan R. Bloem
- Department of Neurology; Donders Institute for Brain, Cognition and Behavior; Radboud University Nijmegen Medical Center; Nijmegen the Netherlands
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Giorelli M, Bagnoli J, Consiglio L, Lopane M, Zimatore GB, Zizza D, Difazio P. Do non-motor symptoms in Parkinson's disease differ from essential tremor before initial diagnosis? A clinical and scintigraphic study. Parkinsonism Relat Disord 2013; 20:17-21. [PMID: 24080307 DOI: 10.1016/j.parkreldis.2013.09.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2013] [Revised: 08/19/2013] [Accepted: 09/03/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Non-motor symptoms (NMS) in Parkinson's disease (PD) are common, increase the patients' disability and have a significantly negative impact on their quality of life. Essential tremor (ET) is also affected by non-motor symptoms and often enters into the differential diagnosis with PD. Brain scintigraphy with [(123)I]β-CIT SPECT is a technique used to facilitate differential diagnosis between PD and ET. METHODS We evaluated both motor impairment (MDS-UPDRS-III) and non-motor symptoms (NMSQuest) in patients who underwent a [(123)I]β-CIT SPECT examination for diagnostic purposes. Both the clinical and the scintigraphic data obtained from the selected PD (n = 31) and ET (n = 22) patients were compared. RESULTS We did not detect a significant difference in the total number of NMS reported by either PD (10.4 ± 4.9) or ET patients (8.41 ± 3.3). PD patients reported more drooling (29%), hyposmia (32.2%), hallucinations (19.3%), difficulty in concentrating (51.6%), orthostatic dizziness (67.7%), falling (19.3%), vivid dreams (32.2%), REM sleep behavior disorder (58%), and diplopia (22.5%) compared with ET patients. PD patients who complained of drooling, orthostatic dizziness, and diplopia had greater denervation of the caudata than did the PD patients who did not report the same symptoms. The differences observed were not associated with differences in age, sex, UPDRS-III score, and the presence/absence of tremor. CONCLUSIONS The declaration of non-motor symptoms is influenced by subjective factors that are widely suggestible. When analyzed early and before receiving a definitive diagnosis, PD patients complain of specific symptoms that seem to depend on different pathogenetic mechanisms.
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Affiliation(s)
- Maurizio Giorelli
- Operative Unit of Neurology, "Dimiccoli" General Hospital, Barletta, Italy.
| | - Junia Bagnoli
- Operative Unit of Nuclear Medicine, "Dimiccoli" General Hospital, Barletta, Italy
| | - Luigi Consiglio
- Operative Unit of Nuclear Medicine, "Dimiccoli" General Hospital, Barletta, Italy
| | - Marialuisa Lopane
- Operative Unit of Nuclear Medicine, "Dimiccoli" General Hospital, Barletta, Italy
| | | | - Daniela Zizza
- Operative Unit of Nuclear Medicine, "Dimiccoli" General Hospital, Barletta, Italy
| | - Pasquale Difazio
- Operative Unit of Nuclear Medicine, "Dimiccoli" General Hospital, Barletta, Italy
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Impact of non-motor symptoms on health-related and perceived quality of life in Parkinson's disease. J Neurol Sci 2013; 332:136-40. [DOI: 10.1016/j.jns.2013.07.005] [Citation(s) in RCA: 103] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2013] [Revised: 06/28/2013] [Accepted: 07/08/2013] [Indexed: 11/21/2022]
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Yong MH, Allen JC, Prakash KM, Tan EK. Differentiating non-motor symptoms in Parkinson's disease from controls and hemifacial spasm. PLoS One 2013; 8:e49596. [PMID: 23408927 PMCID: PMC3569455 DOI: 10.1371/journal.pone.0049596] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2012] [Accepted: 10/15/2012] [Indexed: 11/23/2022] Open
Abstract
Background and Aims Non-motor symptoms (NMS) are important manifestations of Parkinson's disease (PD) that reduce patients' health-related quality of life. Some NMS may also be caused by age-related changes, or manifested as a psychological reaction to a chronic neurological condition. This case-control study compared the NMS burden among PD patients, healthy controls and hemifacial spasm (HFS) patients. In addition, we determined the NMS that discriminated between PD and non-PD subjects. Methods 425 subjects were recruited from a tertiary hospital in Singapore (200 PD patients, 150 healthy controls and 75 HFS patients). NMS burden in subjects was measured using the Non-Motor Symptoms Scale (NMSS). Results NMSS total score was significantly higher in PD patients (37.9±2.6) compared to healthy controls (11.2±0.9) (p<0.0001) and HFS patients (18.0±2.1) (p<0.0001). In addition, NMSS total score was significantly higher in HFS patients compared to healthy controls (p = 0.003). PD patients experienced a higher NMS burden than healthy controls in all domains, and a higher NMS burden than HFS patients in all but attention/memory and urinary domains. NMS burden for HFS and healthy controls differed only in the sleep/fatigue and urinary domains. Using stepwise logistic regression, problems of ‘constipation’, ‘restless legs’, ‘dribbling saliva’, ‘altered interest in sex’ and ‘change in taste or smell’ were found to have significant discriminative power in differentiating between PD patients and healthy controls and between PD patients and HFS patients. Conclusion PD patients experienced a greater overall NMS burden compared to both healthy controls and HFS patients. HFS patients demonstrated a higher NMS burden than controls, and some NMS may be common to chronic neurological conditions while others are more specific to PD. Differentiating patients using NMS domains may help refine the clinical management of NMS in PD patients.
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Affiliation(s)
- Ming-Hui Yong
- Department of Neurology, National Neuroscience Institute, Singapore, Singapore
- Duke-NUS Graduate Medical School, Singapore, Singapore
| | - John C. Allen
- Duke-NUS Graduate Medical School, Singapore, Singapore
| | - Kumar M. Prakash
- Department of Neurology, National Neuroscience Institute, Singapore, Singapore
- Duke-NUS Graduate Medical School, Singapore, Singapore
| | - Eng-King Tan
- Department of Neurology, National Neuroscience Institute, Singapore, Singapore
- Duke-NUS Graduate Medical School, Singapore, Singapore
- * E-mail:
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59
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Nonmotor symptoms more closely related to Parkinson's disease: Comparison with normal elderly. J Neurol Sci 2013; 324:70-3. [DOI: 10.1016/j.jns.2012.10.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2012] [Revised: 09/11/2012] [Accepted: 10/11/2012] [Indexed: 12/11/2022]
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Non-motor symptoms of Parkinson's disease: the patient's perspective. J Neural Transm (Vienna) 2012; 120:531-5. [PMID: 23224635 PMCID: PMC3611030 DOI: 10.1007/s00702-012-0928-2] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2012] [Accepted: 11/16/2012] [Indexed: 12/29/2022]
Abstract
Parkinson's disease (PD) can be manifested in many different ways. Although motor dysfunction represents the best characterised of the symptoms, the non-motor symptoms (NMS) of the condition can be equally disabling for people. These have been highlighted as being an issue of particular importance by people with PD. A comprehensive postal survey of members of the charity Parkinson's UK took place in 2008. This resulted in returns from 10,101 people with PD. The self-completed Non-Motor Questionnaire (NMSQuest) and quality of life scale (PDQ-8) were contained within the survey. The results showed that the percentage of people with PD experiencing NMS increased with the duration of the disease. However, people who had the younger onset form of the condition reported a greater impact of NMS, particularly in the areas of memory, depression and sleep function. There is an inverse correlation between NMS and (PDQ-8 scale). A significant number of people with PD reported that they experienced problems with olfaction, taste, nocturia and constipation prior to diagnosis and these may help to serve as a future biomarker for the condition. Although our understanding of PD-associated NMS has increased considerably in the recent past, there is still a general lack of awareness of the importance of NMS for people with PD. Further research is required to identify the best treatments that should be employed to address them.
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Solla P, Cannas A, Ibba FC, Loi F, Corona M, Orofino G, Marrosu MG, Marrosu F. Gender differences in motor and non-motor symptoms among Sardinian patients with Parkinson's disease. J Neurol Sci 2012; 323:33-9. [PMID: 22935408 DOI: 10.1016/j.jns.2012.07.026] [Citation(s) in RCA: 119] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2012] [Revised: 07/07/2012] [Accepted: 07/11/2012] [Indexed: 01/25/2023]
Abstract
BACKGROUND Parkinson's disease (PD) occurs more frequently in men than in women and a higher risk for PD development in males compared with females has been hypothesized, suggesting gender may be a significant factor in the development and progression of parkinsonism. To date, gender differences in non-motor symptoms are under-reported. OBJECTIVE To assess gender differences in motor and non-motor symptoms among Sardinian PD patients. METHODS One hundred fifty-six (91 male and 65 female) consecutive Sardinian PD outpatients were included in this analysis. Modified Hoehn and Yahr scale and UPDRS were used to assess motor symptoms, while non-motor disturbances were evaluated with the non-motor symptoms scale (NMSS). Presence of depression, anxiety and other iatrogenic behavioral disorders was also investigated. In order to determine how gender differences could be specific to PD, 132 age-matched normal controls were assessed with the NMSS. RESULTS Women were more likely than men to present with tremor as initial symptom (p<.025) and worse UPDRS instability score (p<.02). NMSS score in females was significantly higher than that in males (p<.018). A significantly higher severity in cardiovascular (p<0.002), sleep/fatigue (p<.018) and mood/apathy (p<.001) domains was observed in female PD patients, while the sexual dysfunction domain was reported with a significantly higher score in male patients (p<.017). Fatigue (p<.03), lack of motivation (p<.015) and sadness (p<.009) were observed significantly more frequent in females, while altered interest in sex was noted as more common in males (p<.001). Frequency of depression (p<.011) and anxiety (p<.001) was significantly higher in females, while male patients had increased frequency of compulsive sexual behaviors (p<.05). There was a significantly higher frequency of non-motor symptoms in eight domains in both male and female PD patients compared with controls (p<.001, for all comparisons, with the exception of urinary disturbances in females: p<.004). Only sexual dysfunctions were not significantly higher in male and female PD patients compared with controls. DISCUSSION The present study highlights the role of gender differences associated with the occurrence of motor and non-motor disorders and our findings indicate that spectrum and severity of non-motor symptoms may present with different gender distribution in PD patients, suggesting a possible sex-related effect.
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Affiliation(s)
- Paolo Solla
- Movement Disorders Center, Department of Neurology, Institute of Neurology, University of Cagliari, Cagliari, Italy.
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Martinez-Martin P, Frades-Payo B, Agüera-Ortiz L, Ayuga-Martinez A. A short scale for evaluation of neuropsychiatric disorders in Parkinson's disease: first psychometric approach. J Neurol 2012; 259:2299-308. [PMID: 22527230 DOI: 10.1007/s00415-012-6490-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2012] [Revised: 03/01/2012] [Accepted: 03/20/2012] [Indexed: 12/23/2022]
Abstract
The neuropsychiatric symptoms and behavioral disorders affecting Parkinson's disease (PD) patients are common and disabling. A PD-specific interview-based 12-item scale, the Scale for Evaluation of Neuropsychiatric Disorders in Parkinson's Disease (SEND-PD), has been developed to assess the severity of neuropsychiatric manifestations. The present study is aimed at testing some basic psychometric attributes of this scale. A total of 633 consecutive patients and their caregivers were included in this cross-sectional, multicenter, observational study. In addition to the tested scale, the following assessments were applied: Hoehn and Yahr staging, Scales for Outcomes in Parkinson's Disease Motor and Psychiatric complications, MiniMental State Examination, Clinical Impression of Severity Index, and the Zarit Caregiver Burden Inventory. Patients in all stages of disease were included and 18.38 % were demented. The SEND-PD was responded by patients (86.16 %), caregivers (13.15 %), or both (0.69 %). Three factors (accounting for 66.63 % of the variance) were identified and considered as subscales: Psychotic symptoms, Mood/Apathy, and Impulse control disorders. The subscales showed satisfactory scaling assumptions (multitrait-item success rate 100 %) and internal consistency (alpha indices >0.70). The convergent validity with other measures of psychiatric symptoms and the discriminant validity to distinguish between categories of patients' age, duration and severity of disease, and dopaminergic treatment were satisfactory. The precision of the scale dimensions was acceptable. The SEND-PD performed as an acceptable, consistent, valid, and precise scale for evaluation of neuropsychiatric symptoms in Parkinson's disease.
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Affiliation(s)
- Pablo Martinez-Martin
- Alzheimer Disease Research Unit, CIEN Foundation, Carlos III Institute of Health, Alzheimer Center Reina Sofia Foundation, C/. Valderrebollo, 5, 28031, Madrid, Spain.
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Gender-related differences in the burden of non-motor symptoms in Parkinson's disease. J Neurol 2012; 259:1639-47. [PMID: 22237822 DOI: 10.1007/s00415-011-6392-3] [Citation(s) in RCA: 182] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2011] [Revised: 12/20/2011] [Accepted: 12/21/2011] [Indexed: 01/24/2023]
Abstract
Differences in the expression of non-motor symptoms (NMS) by Parkinson's disease (PD) patients may have important implications for their management and prognosis. Gender is a basic epidemiological variable that could influence such expression. The present study evaluated the prevalence and severity of NMS by gender in an international sample of 951 PD patients, 62.63% males, using the non-motor symptoms scale (NMSS). Assessments for motor impairment and complications, global severity, and health state were also applied. All disease stages were included. No significant gender differences were found for demographic and clinical characteristics. For the entire sample, the most prevalent symptoms were Nocturia (64.88%) and Fatigue (62.78%) and the most prevalent affected domains were Sleep/Fatigue (84.02%) and Miscellaneous (82.44%). Fatigue, feelings of nervousness, feelings of sadness, constipation, restless legs, and pain were more common and severe in women. On the contrary, daytime sleepiness, dribbling saliva, interest in sex, and problems having sex were more prevalent and severe in men. Regarding the NMSS domains, Mood/Apathy and Miscellaneous problems (pain, loss of taste or smell, weight change, and excessive sweating) were predominantly affected in women and Sexual dysfunction in men. No other significant differences by gender were observed. To conclude, in this study significant differences between men and women in prevalence and severity of fatigue, mood, sexual and digestive problems, pain, restless legs, and daytime sleepiness were found. Gender-related patterns of NMS involvement may be relevant for clinical trials in PD.
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