Parkinson Hastalarında Motor Olmayan Bulguların NMSQ Anketi Kullanılarak Değerlendirilmesi

Year 2020, Volume: 1 Issue: 1, 47 - 55, 01.01.2020

Şeyda Çankaya Sibel Altınayar

Abstract

İdiyopatik Parkinson Hastalığı (IPH) sık görülen bir hareket bozukluğudur. Hastaların özürlülüğüne motor belirtiler kadar, motor olmayan belirtiler de yol açar. Motor olmayan belirtiler (MOB) Parkinson hastalarında %88 oranında görülür. Bu semptomlar, hastaların yaşam kalitesinin bozulmasında önemli rol oynar. Hastaların modern ve özenli sağlık bakımlarına ulaşabilmesi için MOB’in tanınması ve tedavisi çok önemlidir. Bu nedenle bir grup uzman tarafından Parkinson hastalarında MOB’i ortaya koymak amacıyla NMSQuest adlı anket tasarlanmıştır. Anket uluslararası çalışmalarla geçerlilik ve güvenilirliğini kazanmıştır. Biz çalışmamızda Parkinson hastalarında MOB’i saptamak amacıyla NMSQuest’i kullanmaya karar verdik. Böylece Türkiye’de bu alanda kullanılabilecek ölçeklerin varlığına dikkat çekmeyi istedik. Ayrıca MOB’de erken teşhis ile tedavinin önemini vurgulamayı amaçladık. Çalışmamıza 29’u kadın, 46 ‘sı erkek olmak üzere toplam 75 İdiyopatik Parkinson hastası alındı. İdiyopatik Parkinson Hastalığı’nın hastalık şiddeti ve evresi, ‘Hoehn-Yahr’ skalası ile değerlendirildi. Sonuçlar güncel literatür eşliğinde tartışıldı. Motor olmayan belirtilerin olgulardaki oranı ve hastalığın evresiyle ilişkisi benzer çalışmalarla karşılaştırıldı. Sonuç olarak erken teşhis ve tedavinin önemi vurgulanmıştır.

Keywords

parkinson hastalığı, NMSQuest anketi, motor olmayan belirtiler

Assessment Of Nonmotor Symptoms In Patients With Parkinson’s Disease By Using Nonmotor Symtoms Questionnaire

Abstract

Idiopathic Parkinson’s Disease (IPD) is a movement disorder with a high prevalance. Not only motor symptoms but also nonmotor symptoms (NMS) cause disability in patients with PD. NMS’s are reported 88% in IPD. NMS play an important role in decreasing the patient’s quality of life. The diagnosis and treatment of NMS are very important for giving modern healthcare to patients with PD. Therefore, a questionnaire called NMSQuest was defined by a group of specialists in order to detect NMS in PD patients. Validity and reliability of NMSQuest have been shown by international studies. In our study, we decided to use NMSQuest to detect NMS in patients with IPD. Thus, we want to draw attention to the presence of scale that can be used in this area in Turkey. We also
aimed to emphasize the importance of early diagnosis and treatment of MOB. A total of 75 patients with IPD, 29 females and 46 males, were included in the study. The severity and stage of IPD were assesed with ‘Hoehn-Yahr’ scale. The results were discussed in light of current literature. The ratio of NMS in the cases and its relationship with the stage of the disease were compared with similar studies. The importance of early diagnosis and treatment of NMS is also emphasized.

Keywords

idiopathic parkinson disease, NMSQuest questionnaire, nonmotor symptoms

References

• 1. Jankovic J. Parkinson’s disease: clinical features and diagnosis. J Neurol Neurosurg Psychiatry. 2008; 79(4): 368-76.
• 2. Jankovic JSK. Movement disorders. In: Bradley WG, Daroff RB, Fenichel GM, Jankovic J, editors Neurology in clinical practice 5th ed Philadelphia: Butterworth- Heinemann (Elsevier). 2008:p. 2081-122.
• 3. Jankovic J, Tolosa E. Parkinson's disease and movement disorders: Lippincott Williams & Wilkins; 2007.
• 4. Simuni T, Sethi K. Nonmotor manifestations of Parkinson's disease. Ann Neurol 2008; 64(S2): S65-S80.
• 5. Fitzsimmons B, Bunting LK. Parkinson's disease. Quality of life issues. Nurs Clin North Am. 1993; 28(4): 807-18.
• 6. Rabinstein A, Shulman L. Management of behavioral and psychiatric problems in Parkinson's disease. Parkinsonism Relat Disord. 2000; 7(1): 41 50.
• 7. Chaudhuri KR, Martinez‐Martin P, Schapira AH, Stocchi F, Sethi K, Odin P, et al. International multicenter pilot study of the first comprehensive self‐completed nonmotor symptoms questionnaire for Parkinson's disease: the NMSQuest study. Mov Disord. 2006; 21(7): 916-23.
• 8. Cheon SM, Ha MS, Park MJ, Kim JW. Nonmotor symptoms of Parkinson's disease: prevalence and awareness of patients and families. Parkinsonism Relat Disord. 2008; 14(4): 286-90.
• 9. Ali G, Wallace K, Schwartz R, DeCarle D, Zagami A, Cook I. Mechanisms of oralpharyngeal dysphagia in patients with Parkinson's disease. Gastroenterology. 1996; 110(2): 383-92.
• 10. Yu B, Xiao ZY, Li JZ, Yuan J, Liu YM. Study of an integrated non-motor symptoms questionnaire for Parkinson's disease. Chin Med J. 2010; 123(11): 1436-40.
• 11. Winge K, Fowler CJ. Bladder dysfunction in Parkinsonism: mechanisms, prevalence, symptoms, and management. Mov Disord. 2006; 21(6): 737-45.
• 12. Jankovic J. Pathophysiology and clinical assessment of parkinsonian symptoms and signs. Handbook of Parkinson's disease: CRC Press; 2003. p. 90-127.
• 13. Chaudhuri KR, Healy DG, Schapira AH. Nonmotor symptoms of Parkinson's disease: diagnosis and management. The Lancet Neurology. 2006; 5(3): 235-45.
• 14. Erdine S, Hamzaoğlu O, Özkan Ö, Balta E, Domaç M. Türkiye’de erişkinlerin ağrı prevalansı. Ağrı 2001; 13(2): 22-30.
• 15. Huber SJ, Shuttleworth EC, Christy JA, Chakeres DW, Curtin A, Paulson GW. Magnetic resonance imaging in dementia of Parkinson's disease. J Neurol Neurosurg Psychiatry. 1989; 52(11): 1221-7.
• 16. Aarsland D, Marsh L, Schrag A. Neuropsychiatric symptoms in Parkinson's disease. Move Disord. 2009; 24(15): 2175-86.
• 17. Bayles KA, Tomoeda CK, Wood JA, Montgomery EB, Cruz RF, Azuma T, et al. Change in cognitive function in idiopathic Parkinson disease. Arch Neurol. 1996; 53(11): 1140-6.
• 18. Portin R, Rinne U. Predictive factors for cognitive deterioration and dementia in Parkinson's disease. Adv Neurol. 1987; 45: 413.
• 19. A Taş AA. Parkinson Hastalığında Kognitif Fonksiyonlar. Demans Dergisi. 2003; 3(1): 30-4.
• 20. Thanvi B, Munshi S, Vijaykumar N, Lo T. Neuropsychiatric non-motor aspects of Parkinson’s disease. Postgrad Med J. 2003; 79(936): 561-5.
• 21. Koller WC, Vetere-Overfield B, Williamson A, Busenbark K, Nash J, Parrish D. Sexual dysfunction in Parkinson's disease. Clin Neuropharmacol. 1990; 13(5): 461-3.
• 22. Singer C, Weiner WJ, Sanchez-Ramos J, Ackerman M. Sexual function in patients with Parkinson's disease. J Neurol Neurosurg Psychiatry. 1991; 54(10): 942.
• 23. Martinez‐Martin P, Schapira AH, Stocchi F, Seti K, Odin P, MacPhee G, et al. Prevalence of nonmotor symptoms in Parkinson's disease in an international setting; study using nonmotor symptoms questionnaire in 545 patients. Mov Disord. 2007; 22(11): 1623-9.
• 24. Aygün D, Türkel Y, Onar MK. Parkinson hastalığında motor olmayan belirtilerin tanı ve tedavisi. Parkinson Hastalığı ve Hareket Bozuklukları Dergisi. 2009; 12: 80-90.
• 25. Factor SA, Brown D. Clozapine prevents recurrence of psychosis in Parkinson's disease. Mov Disord. 1992; 7(2): 125-31.
• 26. Rabey JM, Treves T, Neufeld M, Orlov E, Korczyn A. Low-dose clozapine in the treatment of levodopa-induced mental disturbances in Parkinson's disease. Neurology. 1995; 45(3): 432-4.