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Proust-Lima C, Saulnier T, Philipps V, Traon APL, Péran P, Rascol O, Meissner WG, Foubert-Samier A. Describing complex disease progression using joint latent class models for multivariate longitudinal markers and clinical endpoints. Stat Med 2023; 42:3996-4014. [PMID: 37461227 DOI: 10.1002/sim.9844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 01/31/2023] [Accepted: 06/26/2023] [Indexed: 09/05/2023]
Abstract
Neurodegenerative diseases are characterized by numerous markers of progression and clinical endpoints. For instance, multiple system atrophy (MSA), a rare neurodegenerative synucleinopathy, is characterized by various combinations of progressive autonomic failure and motor dysfunction, and a very poor prognosis. Describing the progression of such complex and multi-dimensional diseases is particularly difficult. One has to simultaneously account for the assessment of multivariate markers over time, the occurrence of clinical endpoints, and a highly suspected heterogeneity between patients. Yet, such description is crucial for understanding the natural history of the disease, staging patients diagnosed with the disease, unravelling subphenotypes, and predicting the prognosis. Through the example of MSA progression, we show how a latent class approach modeling multiple repeated markers and clinical endpoints can help describe complex disease progression and identify subphenotypes for exploring new pathological hypotheses. The proposed joint latent class model includes class-specific multivariate mixed models to handle multivariate repeated biomarkers possibly summarized into latent dimensions and class-and-cause-specific proportional hazard models to handle time-to-event data. Maximum likelihood estimation procedure, validated through simulations is available in the lcmm R package. In the French MSA cohort comprising data of 598 patients during up to 13 years, five subphenotypes of MSA were identified that differ by the sequence and shape of biomarkers degradation, and the associated risk of death. In posterior analyses, the five subphenotypes were used to explore the association between clinical progression and external imaging and fluid biomarkers, while properly accounting for the uncertainty in the subphenotypes membership.
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Affiliation(s)
- Cécile Proust-Lima
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, U1219, Bordeaux, France
- Inserm, CIC1401-EC, Bordeaux, France
| | - Tiphaine Saulnier
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, U1219, Bordeaux, France
| | - Viviane Philipps
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, U1219, Bordeaux, France
| | - Anne Pavy-Le Traon
- MSA Reference Center and CIC-1436, Department of Clinical Pharmacology and Neurosciences, NeuroToul COEN Center, University of Toulouse 3, CHU of Toulouse, INSERM, Toulouse, France
| | - Patrice Péran
- ToNIC, Toulouse NeuroImaging Center, Univ Toulouse, Inserm, UPS, Toulouse, France
| | - Olivier Rascol
- MSA Reference Center and CIC-1436, Department of Clinical Pharmacology and Neurosciences, NeuroToul COEN Center, University of Toulouse 3, CHU of Toulouse, INSERM, Toulouse, France
| | - Wassilios G Meissner
- Univ. Bordeaux, CNRS, IMN, UMR5293, Bordeaux, France
- Dept. Medicine, University of Otago, Christchurch, and New Zealand Brain Research Institute, Christchurch, New Zealand
| | - Alexandra Foubert-Samier
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, U1219, Bordeaux, France
- Inserm, CIC1401-EC, Bordeaux, France
- Univ. Bordeaux, CNRS, IMN, UMR5293, Bordeaux, France
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Hu WZ, Cao LX, Yin JH, Zhao XS, Piao YS, Gu WH, Ma JH, Wan ZR, Huang Y. Non-motor symptoms in multiple system atrophy: A comparative study with Parkinson's disease and progressive supranuclear palsy. Front Neurol 2023; 13:1081219. [PMID: 36756345 PMCID: PMC9901543 DOI: 10.3389/fneur.2022.1081219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 12/29/2022] [Indexed: 01/24/2023] Open
Abstract
Background Non-motor symptoms (NMS) are compulsory clinical features for the clinical diagnosis of multiple system atrophy (MSA), some of which precede motor symptoms onset. To date, few studies have systematically investigated NMS in MSA and the timing of presenting NMS as the disease progresses. Clinically, MSA is difficult to be differentiated from Parkinson's disease (PD) and progressive supranuclear palsy (PSP), and the differences in NMS between MSA and PD/PSP remain unclear. The aim of this study was to compare the burden of NMS between MSA and PD/PSP and to delineate the timing of NMS presentation relative to the onset of motor symptoms in MSA. Methods A total of 61, 87, and 30 patients with MSA, PD, and PSP, respectively, were enrolled in this study. NMS was systematically assessed in all patients using the NMS scale (NMSS), and the onset of NMS relative to the onset of motor symptoms in MSA was investigated. Results MSA group had higher total NMSS scores (82.15 ± 46.10) than the PD (36.14 ± 30.78) and PSP (50.30 ± 55.05) groups (p < 0.001 overall). The number distribution pattern of the NMS was significantly different among the three parkinsonian disorders (p < 0.001 overall). In total, 85.2% of patients with MSA had more than 10 NMS, which was significantly higher than PD (28.7%) and PSP (33.3%). The frequency and scores of many NMSS subdomains and symptoms were higher in MSA than in PD and PSP (all p < 0.05). Multivariate logistic regression analysis revealed that patients with fainting, lack of motivation, swallowing, and loss of sexual interest could be attributed to MSA rather than PD or PSP, while patients with loss of concentration and forgetfulness were characteristic features of PD or PSP rather than MSA. REM-sleep behavior disorder (RBD), constipation, problems having sex, and loss of sexual interest preceded the motor symptoms onset of MSA by 2.81 ± 4.51, 1.54 ± 6.32, 1.35 ± 4.70, and 0.45 ± 3.61 years, respectively. Conclusion The NMS spectrum in MSA differs from that of PD and PSP. Patients with MSA have a higher NMS burden than patients with PD or PSP. RBD, constipation, problems having sex, and loss of sexual interest may become early diagnostic clinical markers of MSA.
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Affiliation(s)
- Wen-Zheng Hu
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China,Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Ling-Xiao Cao
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China,Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Jin-Hui Yin
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China,Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xue-Song Zhao
- Traditional Chinese Medical Department, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Ying-Shan Piao
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Wei-Hong Gu
- Neurology Department, China-Japan Friendship Hospital, Beijing, China
| | - Jing-Hong Ma
- Neurology Department, XuanWu Hospital, Capital Medical University, Beijing, China
| | - Zhi-Rong Wan
- Department of Neurology, Aerospace Central Hospital, Beijing, China
| | - Yue Huang
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China,Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China,Department of Pharmacology, Faculty of Medicine and Health, School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia,*Correspondence: Yue Huang ✉
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van Wamelen DJ, Martinez‐Martin P, Weintraub D, Schrag A, Antonini A, Falup‐Pecurariu C, Odin P, Ray Chaudhuri K. The Non-Motor Symptoms Scale in Parkinson's disease: Validation and use. Acta Neurol Scand 2021; 143:3-12. [PMID: 32813911 DOI: 10.1111/ane.13336] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 08/09/2020] [Accepted: 08/16/2020] [Indexed: 12/13/2022]
Abstract
The Non-Motor Symptoms Scale (NMSS) was developed and validated in 2007 as the first instrument for the comprehensive assessment of a range of non-motor symptoms in Parkinson's disease (PD). Thirteen years have elapsed since its introduction and extensive international validation with good psychometric attributes has been carried out. Here, we review the validation data of the NMSS and its cross-validity with other scales, and describe the key evidence derived from use of the NMSS in clinical studies. To date, over 100 clinical studies and trials have made use of it as an outcome measure, showing consistent and strong correlations between NMSS burden and health-related quality of life measures. Moreover, the scale has shown to be capable of detecting longitudinal changes in non-motor symptoms, where studies have shown differential changes over time of several of the NMSS domains. The scale has become a key outcome in several randomized clinical trials. Highlighting the prevalence and importance of non-motor symptoms to quality of life in patients with PD, the development of NMSS has also been useful in signposting clinical and biomarker based research addressing non-motor symptoms in PD.
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Affiliation(s)
- Daniel J. van Wamelen
- Department of Neurosciences Institute of Psychiatry, Psychology & Neuroscience King’s College London London UK
- Parkinson's Foundation Centre of Excellence King's College Hospital London UK
- Radboud University Medical Centre Department of Neurology Donders Institute for Brain, Cognition and Behaviour Nijmegen The Netherlands
| | - Pablo Martinez‐Martin
- Center for Networked Biomedical Research in Neurodegenerative Diseases (CIBERNED) Carlos III Institute of Health Madrid Spain
| | - Daniel Weintraub
- Perelman School of Medicine University of Pennsylvania Philadelphia PA USA
- Parkinson's Disease Research Education and Clinical Center (PADRECC) Philadelphia Veterans Affairs Medical Center Philadelphia PA USA
| | - Anette Schrag
- Department of Clinical and Movement Neurosciences UCL Institute of Neurology University College London London UK
| | - Angelo Antonini
- Parkinson and Movement Disorders Unit Department of Neuroscience University of Padua Padua Italy
| | - Cristian Falup‐Pecurariu
- Department of Neurology Faculty of Medicine Transilvania University County Emergency Clinic Hospital Brașov Romania
| | - Per Odin
- Faculty of Medicine University of Lund Lund Sweden
- University Hospital Reinkenheide Bremerhaven Germany
| | - Kallol Ray Chaudhuri
- Department of Neurosciences Institute of Psychiatry, Psychology & Neuroscience King’s College London London UK
- Parkinson's Foundation Centre of Excellence King's College Hospital London UK
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Nonmotor symptoms of 820 Taiwanese patients with Parkinson's disease: an exploratory-comparative study. J Neurol 2020; 267:1499-1507. [PMID: 32025799 DOI: 10.1007/s00415-020-09708-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Revised: 01/09/2020] [Accepted: 01/11/2020] [Indexed: 01/06/2023]
Abstract
INTRODUCTION Nonmotor symptoms (NMSs) severely affect the daily quality of life of patients with Parkinson's disease (PD). Although many studies have documented the clinical characteristics of NMSs in PD patients, some issues remain unaddressed. The severity and gender distribution of NMSs in Asian and the Western patients differ. The correlations between clinical characteristics and NMS manifestations remain unclear. We studied these relationships in a large cohort of Taiwanese PD patients. METHODS Patients with PD were recruited from the outpatient clinic of a tertiary medical center and evaluated with standardized assessment protocols, including the NonMotor Symptoms Scale (NMSS), Unified Parkinson's Disease Rating Scale (UPDRS), Hoehn and Yahr (H&Y) scale, Mini-Mental Status Examination, and Montreal Cognitive Assessment. RESULTS Among 820 patients enrolled, 41.8% were female. The prevalence of the NMSs was 96.5%, with attention/memory (79.51%) being the most frequently involved domain. The mean severity score on the NMSS was 36.48 ± 34.30. Male patients reported higher NMS prevalence and severity than female patients, mostly in the gastrointestinal tract and urinary domains. We found that the severity of NMSs was correlated with disease duration, UPDRS Part III score, and H&Y stage. CONCLUSION Although they exhibited similar NMS prevalence, Taiwanese PD patients reported less intense NMSs compared with those reported by Western patients. Furthermore, the NMS items our patients emphasized and gender discrepancies were distinct from those in Western studies.
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Fei L, Zhou D, Ding ZT. The efficacy and safety of rotigotine transdermal patch for the treatment of sleep disorders in Parkinson's disease: a meta-analysis. Sleep Med 2019; 61:19-25. [PMID: 31272824 DOI: 10.1016/j.sleep.2019.05.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 05/02/2019] [Accepted: 05/03/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Sleep disturbances are one of the most common non-motor symptoms in Parkinson's disease (PD), and more frequently in advancing stage, almost 67-78.6% of PD patients experience some form of sleep disturbance [1-3]. Our objective is to conduct a meta-analysis of randomized controlled trials to demonstrate the efficacy and safety of rotigotine (RTG) transdermal patch for the treatment of sleep disorder in PD. METHODS RevMan5.3 from the Cochrane Library was used to conduct a meta-analysis, primary outcome measure was score of sleep scale in Parkinson's Disease, the mean change in scores of each subscale was treated as a continuous variable and the weighted mean difference (WMD) was calculated as the difference between the mean scale of sleep score in the treatment and control groups. RESULTS A total of five studies were included, and primary outcome measured by "PDSS" or "PDSS-2" score revealed a significant improvement in RTG treated patients compared to control [WMD: -6.66, 95% CI: (-8.54, -4.79), p < 0.0001], after the removal of two articles with high heterogeneity, the meta-analysis conclusion remained robust to methodological changes [WMD -3.90, 95%CI (-6.11, -1.69), p = 0.0005] and distinctly decreased heterogeneity was shown in the final result (I2 = 7%). CONCLUSIONS As for the safety of RTG, it is well tolerated and safe [WMD: 1.68, 95%CI: (1.33, 2.13), p < 0.0001], application site reaction and nausea are among the most frequent side effects.
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Affiliation(s)
- Lu Fei
- Department & Institute of Neurology, Huashan Hospital, Fudan University, 12 Wulumuqi Zhong Road, Shanghai, 200040, China.
| | - Dao Zhou
- Department & Institute of Neurology, Zhuzhou Central Hospital, 116 Changjiang Nan Road, ZhuZhou, Hunan, 412007, China.
| | - Zheng-Tong Ding
- Department & Institute of Neurology, Huashan Hospital, Fudan University, 12 Wulumuqi Zhong Road, Shanghai, 200040, China.
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Ray Chaudhuri K, Antonini A, Robieson WZ, Sanchez-Soliño O, Bergmann L, Poewe W. Burden of non-motor symptoms in Parkinson's disease patients predicts improvement in quality of life during treatment with levodopa-carbidopa intestinal gel. Eur J Neurol 2018; 26:581-e43. [PMID: 30353942 PMCID: PMC6590168 DOI: 10.1111/ene.13847] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2018] [Accepted: 10/12/2018] [Indexed: 01/04/2023]
Abstract
BACKGROUND AND PURPOSE GLORIA, a registry conducted with 375 advanced Parkinson's disease patients treated with levodopa-carbidopa intestinal gel (LCIG) for 24 months in routine clinical care, demonstrated significant reductions from baseline in 'off' time and 'on' time with dyskinesia and improvements in the Non-Motor Symptom Scale (NMSS) total and individual domain scores, and in Parkinson's Disease Questionnaire 8 item (PDQ-8) total score. METHODS Associations between baseline NMSS burden (NMSB), the multi-domain NMSS total score and the PDQ-8 total score were investigated for 233 patients. Baseline NMSB was assigned to five numerical categories defined by the NMSS total cutoff scores (0-20, 21-40, 41-60, 61-80 and >80). Pearson and Spearman correlations were calculated at month 24. RESULTS The response of LCIG was assessed using validated criteria after 24 months. The proportion of patients decreasing ≥ 30 NMSS score points was 47% in the most affected NMSB category (NMSS total score > 80). A positive association was noted between baseline NMSB and NMSS total score (0.57, P < 0.0001), as well as between NMSS total score and PDQ-8 total score (0.46, P < 0.0001). Associations between improvements of the NMSS domain sleep/fatigue and PDQ-8 total score (0.32, P = 0.0001) as well as between the NMSS domain mood/cognition and PDQ-8 total score (0.37, P < 0.0001) were also shown. CONCLUSIONS This analysis demonstrated positive associations between NMSS baseline burden and improvements of non-motor symptoms. Improvements of non-motor symptoms were associated with improved quality of life in advanced parkinsonian patients during a 2-year treatment with LCIG and reflect the long-term non-motor efficacy of this treatment.
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Affiliation(s)
- K Ray Chaudhuri
- Parkinson Foundation International Centre of Excellence, King's College Hospital, Denmark Hill, London, UK.,Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - A Antonini
- Department of Neuroscience, University of Padua, Padua, Italy
| | | | | | | | - W Poewe
- Medical University of Innsbruck, Innsbruck, Austria
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Arie L, Herman T, Shema-Shiratzky S, Giladi N, Hausdorff JM. Do cognition and other non-motor symptoms decline similarly among patients with Parkinson's disease motor subtypes? Findings from a 5-year prospective study. J Neurol 2017; 264:2149-2157. [PMID: 28879438 DOI: 10.1007/s00415-017-8605-x] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 08/22/2017] [Accepted: 08/23/2017] [Indexed: 11/24/2022]
Abstract
Among patients with Parkinson's disease (PD), a wide range of motor and non-motor symptoms (NMS) are evident. PD is often divided into tremor dominant (TD) and postural instability gait difficulty (PIGD) motor subtypes. We evaluated the effect of disease duration and aimed to characterize whether there are differences in the deterioration of cognitive function and other NMS between the PIGD and TD subtypes. Sixty-three subjects were re-evaluated at the follow-up visit about 5 years after baseline examination. Cognitive function and other NMS were assessed. At follow-up, the PIGD and TD groups were similar with respect to medications, comorbidities and disease-related symptoms. There was a significant time effect for all measures, indicating deterioration and worsening in both groups. However, cognitive scores, particularly those related to executive function, became significantly worse in the PIGD with a more moderate decrease in the TD group. For example, the computerized global cognitive score declined in the PIGD group from 94.21 ± 11.88 to 83.91 ± 13.76, p < 0.001. This decline was significantly larger (p = 0.03) than the decrease observed in the TD group (96.56 ± 10.29 to 92.21 ± 14.20, p = 0.047). A significant group × time interaction effect was found for the change in global cognitive score (p = 0.047), the executive function index (p = 0.002) and accuracy on a motor-cognitive catch game (p = 0.008). In contrast, several NMS including depression, health-related quality of life and fear of falling deteriorated in parallel in both subtypes, with no interaction effect. The present findings highlight the difference in the natural history of the disease between the two PD "motor" subtypes. While the PIGD group demonstrated a significant cognitive decline, especially in executive functions, a more favorable course was observed in the TD subtype. This behavior was not seen in regards to the other NMS.
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Affiliation(s)
- L Arie
- Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, 6 Weizman Street, 64239, Tel Aviv, Israel.,Department of Physical Therapy, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Talia Herman
- Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, 6 Weizman Street, 64239, Tel Aviv, Israel.
| | - S Shema-Shiratzky
- Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, 6 Weizman Street, 64239, Tel Aviv, Israel
| | - N Giladi
- Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, 6 Weizman Street, 64239, Tel Aviv, Israel.,Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel.,Department of Neurology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - J M Hausdorff
- Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, 6 Weizman Street, 64239, Tel Aviv, Israel.,Department of Physical Therapy, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel.,Rush Alzheimer's Disease Center, Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, USA
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Wang Y, Yang Y, Wu H, Lan D, Chen Y, Zhao Z. Effects of Rotigotine on REM Sleep Behavior Disorder in Parkinson Disease. J Clin Sleep Med 2016; 12:1403-1409. [PMID: 27568909 DOI: 10.5664/jcsm.6200] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 06/30/2016] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES REM sleep behavior disorder (RBD) is a common manifestation of Parkinson disease (PD). In this study, we assessed the effects of rotigotine transdermal patch on RBD features in patients with PD. METHODS In this prospective open-label study, eleven PD patients with untreated RBD were administered rotigotine patches for up to seven months to ameliorate their parkinsonism. The severities of their RBD symptoms before and after rotigotine therapy were evaluated through patient and bed partner interviews, a validated evaluation scale (REM sleep behavior disorder questionnaire-Hong Kong, RBDQ-HK), and blinded assessments based on video-polysomnographic (VPSG) measure. RESULTS Rotigotine improved parkinsonism and subjective sleep quality in PD patients with RBD. The RBDQ-HK total score, especially the Factor 2 score, was decreased, which demonstrated that the subjective severity of RBD symptoms was improved after rotigotine treatment, especially the frequency and severity of abnormal RBD-related motor behaviors. The VPSG analyses showed that the total sleep time (TST) and stage 1% were increased and that the PLMS index was decreased. However, no differences in the RBD-related sleep measures were observed. CONCLUSIONS The improved RBD symptoms and VPSG measures of PD patients in this study (TST, stage 1%, and PLMS index) suggest that, in PD, rotigotine may partially improve RBD-related symptoms. Rotigotine should be considered to be an optional drug for the treatment of RBD symptoms in PD.
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Affiliation(s)
- Yan Wang
- Department of Neurology, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Yuechang Yang
- Department of Neurology, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Huijuan Wu
- Sleep Center, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Danmei Lan
- Department of Neurology, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Ying Chen
- Sleep Center, Changzheng Hospital, Second Military Medical University, Shanghai, China
| | - Zhongxin Zhao
- Department of Neurology, Changzheng Hospital, Second Military Medical University, Shanghai, China
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Parkinson’s Disease Sleep Scale 2: application in an Italian population. Neurol Sci 2015; 37:283-8. [DOI: 10.1007/s10072-015-2409-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Accepted: 10/23/2015] [Indexed: 10/22/2022]
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Effects of Night-Time Use of Rotigotine on Nocturnal Symptoms in Parkinson's Disease. PARKINSONS DISEASE 2015; 2015:475630. [PMID: 26576319 PMCID: PMC4632005 DOI: 10.1155/2015/475630] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 09/30/2015] [Indexed: 11/18/2022]
Abstract
Objectives. This open-label study assessed the efficacy and safety of exclusive night-time administration of transdermal rotigotine in patients with nocturnal and early morning PD symptoms. Methods. Patients with PD and nocturnal and early morning symptoms received transdermal rotigotine patches (2–16 mg/24 h) applied in the evening and removed in the morning for 3 months. Sleep disturbance was assessed with modified Parkinson's Disease Sleep Scale (PDSS-2). Other outcomes included a pain visual analogue scale (VAS) and short-form Parkinson's Disease Questionnaire (PDQ-8) for quality of life. Results. 74 patients completed treatment in this study. At the end of treatment, PDSS-2 total score had improved by mean 10.9 points from baseline (p < 0.001). All three PDSS-2 domain scores (sleep disturbances, nocturnal motor symptoms, and nocturnal symptoms) were also significantly improved by 41%, 56%, and 48%, respectively (p < 0.001). VAS-pain score decreased from 3.2 to 2.3 (p < 0.001). PDQ-8 score decreased from 23.8 to 18.1 (p < 0.001). The most frequently reported adverse events included nausea (9%), anxiety (4%), and dizziness (4%). Conclusions. Night-time administration of transdermal rotigotine is an effective and well tolerated treatment for nocturnal symptoms in patients with PD.
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Minimal Clinically Important Difference on Parkinson's Disease Sleep Scale 2nd Version. PARKINSONS DISEASE 2015; 2015:970534. [PMID: 26539303 PMCID: PMC4619979 DOI: 10.1155/2015/970534] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/28/2015] [Accepted: 09/10/2015] [Indexed: 11/30/2022]
Abstract
Background and Aims. The aim of the present study was to determine the estimates of minimal clinically important difference for Parkinson's Disease Sleep Scale 2nd version (PDSS-2) total score and dimensions. Methods. The subject population consisted of 413 PD patients. At baseline, MDS-UPDRS, Hoehn-Yahr Scale, Mattis Dementia Rating Scale, and PDSS-2 were assessed. Nine months later the PDSS-2 was reevaluated with the Patient-Reported Global Impression Improvement Scale. Both anchor-based techniques (within patients' score change method and sensitivity- and specificity-based method by receiver operating characteristic analysis) and distribution-based approaches (effect size calculations) were utilized to determine the magnitude of minimal clinically important difference. Results. According to our results, any improvements larger than −3.44 points or worsening larger than 2.07 points can represent clinically important changes for the patients. These thresholds have the effect size of 0.21 and −0.21, respectively. Conclusions. Minimal clinically important differences are the smallest change of scores that are subjectively meaningful to patients. Studies using the PDSS-2 as outcome measure should utilize the threshold of −3.44 points for detecting improvement or the threshold of 2.07 points for observing worsening.
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Cognitive function and other non-motor features in non-demented Parkinson’s disease motor subtypes. J Neural Transm (Vienna) 2014; 122:1115-24. [DOI: 10.1007/s00702-014-1349-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Accepted: 12/01/2014] [Indexed: 10/24/2022]
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Rizos A, Martinez-Martin P, Odin P, Antonini A, Kessel B, Kozul TK, Todorova A, Douiri A, Martin A, Stocchi F, Dietrichs E, Chaudhuri KR. Characterizing motor and non-motor aspects of early-morning off periods in Parkinson's disease: An international multicenter study. Parkinsonism Relat Disord 2014; 20:1231-5. [DOI: 10.1016/j.parkreldis.2014.09.013] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Revised: 08/10/2014] [Accepted: 09/04/2014] [Indexed: 10/24/2022]
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