Parkinson's Disease Profile – A 17-Year Patient Analysis

Abstract

Objective: Idiopathic Parkinson's disease (IPD) is a progressive degenerative disease, which increases over the age of 65 years and causes disability in advanced stages. The main pathology is the degeneration of the basal ganglia, especially the substantia nigra. In the clinic, motor and non-motor findings (NMF) are seen, and treatment approach is symptomatic. Factors that increase the risk in Parkinson's disease are male gender, old age, white race, environmental conditions, trauma, vascular diseases, family history, and genetic mutations. In this study, idiopathic Parkinson's patients who came to our movement disorders outpatient clinic in the last 17 years were evaluated retrospectively. We aimed to determine the IPD profile in our region through demographic and clinical findings and treatments used and compare the results with the literature. Methods: We evaluated 1150 patients admitted to the neurology department of movement disorders outpatient clinic due to parkinsonism. Five hundred seventy-eight patients with IPD were included in the study. Demographic data such as age, sex, place of birth, place of residence (rural/urban), comorbidities, family history, and habits were recorded. Results: A total of 63.5% of the patients were male. The mean age of the patients was 68.51(SD ± 10.35) years old for males and 68.37(SD ± 11.22) years old for females, 62.61(SD ± 11.31) for males and 62.55(SD ± 12.46) for females. 66.4% of the patients had the first clinical finding as tremor, while 55.4% had the tremor as the leading complaint. It was seen that 57% of the patients had NMF. It was observed that 52.8% of the patients did not have dementia. As the clinical stage progressed, it was determined that there was a significant increase in dementia rate. Hypertension (HT) (M/F%:35,2/47,2 p=0.01) and thyroid diseases (M/F%:2.3/10.3 p=0,00) were more frequent in female patients than in male patients. Impulsive-compulsive behaviors (ICBs) which are treatment-related problems were more common in males than in females (M/F%:17.8/8.5 p=0,00). Conclusion: The results were found to be similar to the literature. In this study, we have noticed the neglected, incomplete, or inadequately questioned parameters in routine-intensive outpatient conditions. Taking these results into consideration, we had the opportunity to correct our shortcomings in our future studies.

Keywords

• Tremor,Bradykinesia

References

1. 1.Bekris LM, Mata IF, Zabetian CP. The Genetics ofParkinson Disease, Journal of Geriatric Psychiatry andNeurology. 2010; 23: 228–42.
2. 2.Arikanoglu A, Hunkar R, Cınar K. Parkinsonismsecondary to bilateral subdural hematoma. Dicle Med J.2011; 38: 247-9.
3. 3.Kalia LV, Lang AE. Parkinson disease in 2015: Evolvingbasic, pathological and clinical concepts in PD. Nat RevNeurol. 2016; 12: 65–6.
4. 4.Gaare JJ, Skeie GO, Tzoulis C, Larsen JP, Tysnes OB.Familial aggregation of Parkinson's disease may affectprogression of motor symptoms and dementia.Movement disorders: official Journal of the MovementDisorder Society. 2017; 32: 241-45.
5. 5.Breckenridge CB, Berry C, Chang ET, Sielken Jr RL,Mandel JS. Association between Parkinson’s Disease andCigarette Smoking, Rural Living, Well-WaterConsumption, Farming and Pesticide Use: SystematicReview and Meta-Analysis. PloS one. 2016; 11: e0151841.
6. 6.Ritz B, Lee PC, Lassen CF, Arah OA. Parkinson diseaseand smoking revisited: ease of quitting is an early sign ofthe disease. Neurology. 2014; 83: 1396–402.
7. 7.PD MED Collaborative Group. Long-term eff ectivenessof dopamine agonists and monoamine oxidase Binhibitors compared with levodopa as initial treatmentfor Parkinson’s disease (PD MED): a large, open-label,pragmatic randomised trial. Lancet. 2014; 384: 1196–205.
8. 8.Martin I, Dawson VL, Dawson TM. Recent advances inthe genetics of Parkinson's disease. Annu Rev GenomicsHum Genet. 2011; 12: 301–25.

9. 9.Driver JA, Logroscino G, Gaziano JM, Kurth T. Incidenceand remaining lifetime risk of Parkinson disease inadvanced age. Neurology. 2009; 72: 432–8.
10. 10.Pringsheim T, Jette N, Frolkis A, Steeves TDL. Theprevalence of Parkinson’s disease: a systematic reviewand meta-analysis. Mov Disord. 2014; 29: 1583–90.
11. 11.Benito-León J1, Bermejo-Pareja F, Rodríguez J, et al.Prevalence of PD and other types of parkinsonism inthree elderly populations of central Spain NeurologicalDisorders in Central Spain (NEDICES) Study Group. Movdisord. 2003; 18: 267-74.
12. 12.Picillo M, Nicoletti A, Fetoni V, et al. The relevance ofgender in Parkinson's disease: a review. J Neurol. 2017Aug; 264(8): 1583-1607. doi: 10.1007/s00415-016-8384-9. Epub 2017 Jan 4.
13. 13.Noyce AJ, Bestwick JP, Silveira-Moriyama L, et al.Meta-analysis of early nonmotor features and risk factors for Parkinson disease. Ann Neurol. 2012; 72: 893–901.
14. 14.Belvisi D, Conte A, Bologna M, et al. Re-emergenttremor in Parkinson's disease, Parkinsonism RelatDisord. 2016; 36:41-46.http://dx.doi.org/10.1016/j.parkreldis. 2016.12.012.
15. 15.Martin WE, Loewenson RB, Resch JA, Baker AB.Parkinson’s disease: clinical analysis of 100 patients.Neurology. 1983; 23: 783-90.
16. 16.Beiske AG, Loge JH, Rønningen A, Svensson E. Pain inParkinson’s disease: Prevalence and characteristics. Pain.2009; 141: 173-7. doi: 10.1016/j.pain.2008.12.004.
17. 17. Hanagasi HA, Akat S, Gurvit H, Yazici J, Emre M. Pain is common in Parkinson's disease. Clinical Neurology andNeurosurgery Clin Neurol Neurosurg. 2011 Jan; 113: 11-13.doi: 10.1016/j.clineuro.2010.07.024.
18. 18.Yoritaka A, Ohizumi H, Tanaka S, Hattori N.Parkinson’s disease with and without REM sleepbehaviour disorder: are there any clinical differences?Eur Neurol. 2009; 61: 164-70.
19. 19.Howell MJ, Schenck CH. Rapid eye movement sleepbehavior disorder and neurodegenerative disease. JAMANeurol. 2015; 72: 707-12.
20. 20.Doty RL. Olfaction in Parkinson’s disease and relateddisorders. Neurobiol Dis. 2012; 46: 527–52.
21. 21.Postuma RB, Gagnon JF, Vendette M, Desjardins C,Montplaisir JY. Olfaction and color vision identifyimpending neurodegeneration in rapid eye movementsleep behavior disorder. Ann Neurol 2011; 69: 811–8.
22. 22.Altinayar S, Oner S, Can S, Kizilay A, Kamisli S, Sarac K.Olfactory disfunction and its relation olfactory bulbvolume in Parkinson's disease. Eur Rev Med PharmacolSci. 2014; 18: 3659-64.
23. 23.Knudsen K, Krogh K, Østergaard K, Borghammer P.Constipation in Parkinson’s disease: Subjectivesymptoms, objective markers, and new perspectives.Movement Disorders. 2017; 32: 94–105.
24. 24.Khedr EM, Fetoh El NA, Khalifa H, Ahmed MA, Beh ElKM. Prevalence of non-motor features in a cohort ofParkinson’s disease patients. Clinical Neurology andNeurosurgery. 2013; 115: 673–7.
25. 25.Pont-Sunyer C, Hotter A, Gaig C, et al. The onset ofnonmotor symptoms in Parkinson’s disease (the ONSETPD study). Movement Disorders. 2015; 30: 229–37.
26. 26.Monchi O, Hanganu A, Bellec P. Markers of cognitivedecline in PD: The case for heterogeneity. Parkinsonism &Related Disorders. 2016; 24: 8-14.
27. 27.Buter TC, van den Hout A, Matthews FE, et al.Dementia and survival in Parkinson disease: a 12-yearpopulation study. Neurology. 2008; 70: 1017-22.