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Evaluation of the Frequency of Non-Motor Symptoms in Idiopathic Parkinson’s Disease by Gender and Disease Stage

Year 2024, , 47 - 53, 31.03.2024
https://doi.org/10.31832/smj.1273461

Abstract

Purpose: Idiopathic Parkinson's Disease (IPD) is a chronic, progressive, neurodegenerative disease affecting basal ganglia, especially the substantia nigra pars compacta, and dopaminergic neurons in the brain stem. Although IPD is defined as a movement disorder with motor symptoms, it also affects many systems such as limbic, autonomic, gastrointestinal, and genitourinary systems. The aim of our study is to evaluate the frequency of NMS in IPD, which is often overlooked in clinical practice and has serious effects on patients' quality of life.
Method: A total of 97 patients were included in the study, 31 of whom were in the mild stage, 30 in the moderate stage, and 36 in the severe stage. REM sleep behavior disorder (RBD), constipation, presence of hyposmia-anosmia, history of appendectomy and excessive daytime sleepiness, depression, orthostatic hypotension, apathy, forgetfulness, hallucinations, sleep problem, pain, fatigue, dizziness, and frequent urination findings have been noted from patients files.
Results: There was no significant difference (p >0,05) between the rates of appendectomy, prodromal stage symptoms, and NMS between genders (Table 2). Only forgetfulness, dreaming and fatigue were found to be statistically significantly (p<0,05) lower in mild-stage IPD patients than in the moderate and severe stages.
Conclusion: In conclusion, NMS consists of many neuropsychiatric, autonomic, and sensory symptoms that can be seen in every stage of IPD from the prodromal stage to the severe stage, and they increase the disability caused by the motor findings of IPD and decrease the quality of life.

References

  • 1. Parsons TD, Rogers SA, Braaten AJ, Woods SP, Tröster AI. Cognitive sequelae of subthalamic nucleus deep brain stimulation in Parkinson’s disease: A meta-analysis. Lancet Neurol. 2006 Jul;5(7):578-88. doi: 10.1016/S1474- 4422(06)70475-6. PMID: 16781988.
  • 2. Bhidayasiri R, Tarsy D. Parkinson’s Disease: On off’ Phenomenon. Mov Disord. 2012;14-15. https://doi. org/10.1007/978-1-60327-426-5_7.
  • 3. Emre M, Hanağası HA, Şahin HA, Yazıcı J. Hareket Bozuklukları. Nöroloji. Öge AE, Baykan B, Bilgiç B. (ed.) 2022;4. basım:665-90
  • 4. Ropper AH, Samuels MA. Adams and Victor’s Principles of Neurology. McGraw-Hill 9. ed, Ohio, 2009;1033-1045.
  • 5. Sauerbier A, Jenner P, Todorova A, Chaudhuri KR. Non motor subtypes and Parkinson’s disease. Parkinsonism Relat Disord. 2016 Jan;22 Suppl 1:S41-6. doi: 10.1016/j. parkreldis.2015.09.027. Epub 2015 Sep 11. PMID: 26459660.
  • 6. Schapira AHV, Chaudhuri KR, Jenner P. Non-motor features of Parkinson disease. Nat Rev Neurosci. 2017 Jul;18(7):435-450. doi: 10.1038/nrn.2017.62. Epub 2017 Jun 8. Erratum in: Nat Rev Neurosci. 2017 Aug;18(8):509. PMID: 28592904.
  • 7. Postuma RB, Berg D, Stern M, Poewe W, Olanow CW, et al. MDS clinical diagnostic criteria for Parkinson’s disease. Mov Disord. 2015 Oct;30(12):1591-601. doi: 10.1002/ mds.26424. PMID: 26474316.
  • 8. Stebbins GT, Goetz CG, Burn DJ, Jankovic J, Khoo TK, Tilley BC. How to identify tremor dominant and postural instability/ gait difficulty groups with the movement disorder society unified Parkinson’s disease rating scale: comparison with the unified Parkinson’s disease rating scale. Mov Disord. 2013 May;28(5):668-70. doi: 10.1002/ mds.25383. Epub 2013 Feb 13. PMID: 23408503.
  • 9. Martínez-Martín P, Rodríguez-Blázquez C, Mario Alvarez, Arakaki T, Arillo VC, Chaná P, et al. Parkinson’s disease severity levels and MDS-Unified Parkinson’s Disease Rating Scale. Parkinsonism Relat Disord. 2015 Jan;21(1):50-4. doi: 10.1016/j.parkreldis.2014.10.026. Epub 2014 Nov 5. PMID: 25466406.
  • 10. Tolosa E, Garrido A, Scholz SW, Poewe W. Challenges in the diagnosis of Parkinson’s disease. Lancet Neurol. 2021 May;20(5):385-397. doi: 10.1016/ S1474-4422(21)00030-2. PMID: 33894193; PMCID: PMC8185633.
  • 11. GBD 2016 Neurology Collaborators. Global, regional, and national burden of neurological disorders, 1990-2016: A systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol. 2019 May;18(5):459-480. doi: 10.1016/S1474-4422(18)30499-X. Epub 2019 Mar 14. PMID: 30879893; PMCID: PMC6459001.
  • 12. Pfeiffer RF. Non-motor symptoms in Parkinson’s disease. Parkinsonism Relat Disord. 2016 Jan;22 Suppl 1:S119- 22. doi: 10.1016/j.parkreldis.2015.09.004. Epub 2015 Sep 3. PMID: 26372623.
  • 13. Poewe W. Non-motor symptoms in Parkinson’s disease. Eur J Neurol. 2008 Apr;15 Suppl 1:14-20. doi: 10.1111/j.1468-1331.2008.02056.x. PMID: 18353132.
  • 14. Solla P, Cannas A, Ibba FC, Loi F, Corona M, Orofino G, et al. Gender differences in motor and non-motor symptoms among Sardinian patients with Parkinson’s disease. J Neurol Sci. 2012 Dec 15;323(1-2):33-9. doi: 10.1016/j. jns.2012.07.026. Epub 2012 Aug 27. PMID: 22935408.
  • 15. Martinez-Martin P, Rodriguez-Blazquez C, Kurtis MM, Chaudhuri KR; NMSS Validation Group. The impact of non-motor symptoms on health-related quality of life of patients with Parkinson’s disease. Mov Disord. 2011 Feb 15;26(3):399-406. doi: 10.1002/mds.23462. Epub 2011 Jan 24. PMID: 21264941.
  • 16. Coelho M, Ferreira JJ. Late-stage Parkinson disease. Nat Rev Neurol. 2012 Aug;8(8):435-42. doi: 10.1038/nrneurol. 2012.126. Epub 2012 Jul 10. PMID: 22777251.
  • 17. Rosqvist K, Odin P, Hagell P, Iwarsson S, Nilsson MH, Storch A. Dopaminergic Effect on Non-Motor Symptoms in Late Stage Parkinson’s Disease. J Parkinsons Dis. 2018;8(3):409-420. doi: 10.3233/JPD-181380. Erratum in: J Parkinsons Dis. 2019;9(2):447-448. PMID: 30056433.
  • 18. Erro R, Picillo M, Vitale C, Amboni M, Moccia M, Longo K, et al. Non-motor symptoms in early Parkinson’s disease: A 2-year follow-up study on previously untreated patients. J Neurol Neurosurg Psychiatry. 2013 Jan;84(1):14- 7. doi: 10.1136/jnnp-2012-303419. Epub 2012 Sep 19. PMID: 22993448.

İdiyopatik Parkinson Hastalığında Non-Motor Semptomların Sıklığının Cinsiyet ve Hastalık Evresine Göre Değerlendirilmesi

Year 2024, , 47 - 53, 31.03.2024
https://doi.org/10.31832/smj.1273461

Abstract

Amaç: İdiyopatik Parkinson Hastalığı (IPH), bazal gangliyonları, özellikle substantia nigra pars compacta'yı ve beyin sapındaki dopaminerjik nöronları etkileyen kronik, ilerleyici, nörodejeneratif bir hastalıktır. İPH, motor semptomları olan bir hareket bozukluğu olarak tanımlansa da limbik, otonomik, gastrointestinal ve genitoüriner sistemler gibi birçok sistemi de etkiler. Çalışmamızın amacı, klinik pratikte sıklıkla gözden kaçan ve hastaların yaşam kalitesi üzerinde ciddi etkileri olan NMS’lerin İPH'de sıklığını değerlendirmektir.
Gereç ve Yöntemler: Çalışmaya 31 hafif evre, 30 orta evre ve 36 ağır evre olmak üzere toplam 97 hasta dahil edildi. REM uykusu davranış bozukluğu (RBD), kabızlık, hiposmi-anosmi varlığı, apendektomi öyküsü ve gündüz aşırı uyku hali, depresyon, ortostatik hipotansiyon, apati, unutkanlık, halüsinasyonlar, uyku problemi, ağrı, yorgunluk, baş dönmesi ve sık idrara çıkma bulguları hasta dosyalarından not edilmiştir.
Bulgular: Cinsiyetler arasında apendektomi, prodromal evre semptomları ve NMS oranları arasında anlamlı fark izlenmedi (p >0,05) (Tablo 2). Sadece unutkanlık, rüya görme ve yorgunluk hafif evre İPH hastalarında orta ve ağır evrelere göre istatistiksel olarak anlamlı düzeyde (p<0,05) daha düşük bulundu.
Sonuç: Sonuç olarak NMS, İPH'nin prodromal evresinden şiddetli evresine kadar her evresinde görülebilen birçok nöropsikiyatrik, otonomik ve duyusal semptomdan oluşur ve İPH'nin motor bulgularının neden olduğu yeti yitimini arttırır ve yaşam kalitesini düşürür.

References

  • 1. Parsons TD, Rogers SA, Braaten AJ, Woods SP, Tröster AI. Cognitive sequelae of subthalamic nucleus deep brain stimulation in Parkinson’s disease: A meta-analysis. Lancet Neurol. 2006 Jul;5(7):578-88. doi: 10.1016/S1474- 4422(06)70475-6. PMID: 16781988.
  • 2. Bhidayasiri R, Tarsy D. Parkinson’s Disease: On off’ Phenomenon. Mov Disord. 2012;14-15. https://doi. org/10.1007/978-1-60327-426-5_7.
  • 3. Emre M, Hanağası HA, Şahin HA, Yazıcı J. Hareket Bozuklukları. Nöroloji. Öge AE, Baykan B, Bilgiç B. (ed.) 2022;4. basım:665-90
  • 4. Ropper AH, Samuels MA. Adams and Victor’s Principles of Neurology. McGraw-Hill 9. ed, Ohio, 2009;1033-1045.
  • 5. Sauerbier A, Jenner P, Todorova A, Chaudhuri KR. Non motor subtypes and Parkinson’s disease. Parkinsonism Relat Disord. 2016 Jan;22 Suppl 1:S41-6. doi: 10.1016/j. parkreldis.2015.09.027. Epub 2015 Sep 11. PMID: 26459660.
  • 6. Schapira AHV, Chaudhuri KR, Jenner P. Non-motor features of Parkinson disease. Nat Rev Neurosci. 2017 Jul;18(7):435-450. doi: 10.1038/nrn.2017.62. Epub 2017 Jun 8. Erratum in: Nat Rev Neurosci. 2017 Aug;18(8):509. PMID: 28592904.
  • 7. Postuma RB, Berg D, Stern M, Poewe W, Olanow CW, et al. MDS clinical diagnostic criteria for Parkinson’s disease. Mov Disord. 2015 Oct;30(12):1591-601. doi: 10.1002/ mds.26424. PMID: 26474316.
  • 8. Stebbins GT, Goetz CG, Burn DJ, Jankovic J, Khoo TK, Tilley BC. How to identify tremor dominant and postural instability/ gait difficulty groups with the movement disorder society unified Parkinson’s disease rating scale: comparison with the unified Parkinson’s disease rating scale. Mov Disord. 2013 May;28(5):668-70. doi: 10.1002/ mds.25383. Epub 2013 Feb 13. PMID: 23408503.
  • 9. Martínez-Martín P, Rodríguez-Blázquez C, Mario Alvarez, Arakaki T, Arillo VC, Chaná P, et al. Parkinson’s disease severity levels and MDS-Unified Parkinson’s Disease Rating Scale. Parkinsonism Relat Disord. 2015 Jan;21(1):50-4. doi: 10.1016/j.parkreldis.2014.10.026. Epub 2014 Nov 5. PMID: 25466406.
  • 10. Tolosa E, Garrido A, Scholz SW, Poewe W. Challenges in the diagnosis of Parkinson’s disease. Lancet Neurol. 2021 May;20(5):385-397. doi: 10.1016/ S1474-4422(21)00030-2. PMID: 33894193; PMCID: PMC8185633.
  • 11. GBD 2016 Neurology Collaborators. Global, regional, and national burden of neurological disorders, 1990-2016: A systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol. 2019 May;18(5):459-480. doi: 10.1016/S1474-4422(18)30499-X. Epub 2019 Mar 14. PMID: 30879893; PMCID: PMC6459001.
  • 12. Pfeiffer RF. Non-motor symptoms in Parkinson’s disease. Parkinsonism Relat Disord. 2016 Jan;22 Suppl 1:S119- 22. doi: 10.1016/j.parkreldis.2015.09.004. Epub 2015 Sep 3. PMID: 26372623.
  • 13. Poewe W. Non-motor symptoms in Parkinson’s disease. Eur J Neurol. 2008 Apr;15 Suppl 1:14-20. doi: 10.1111/j.1468-1331.2008.02056.x. PMID: 18353132.
  • 14. Solla P, Cannas A, Ibba FC, Loi F, Corona M, Orofino G, et al. Gender differences in motor and non-motor symptoms among Sardinian patients with Parkinson’s disease. J Neurol Sci. 2012 Dec 15;323(1-2):33-9. doi: 10.1016/j. jns.2012.07.026. Epub 2012 Aug 27. PMID: 22935408.
  • 15. Martinez-Martin P, Rodriguez-Blazquez C, Kurtis MM, Chaudhuri KR; NMSS Validation Group. The impact of non-motor symptoms on health-related quality of life of patients with Parkinson’s disease. Mov Disord. 2011 Feb 15;26(3):399-406. doi: 10.1002/mds.23462. Epub 2011 Jan 24. PMID: 21264941.
  • 16. Coelho M, Ferreira JJ. Late-stage Parkinson disease. Nat Rev Neurol. 2012 Aug;8(8):435-42. doi: 10.1038/nrneurol. 2012.126. Epub 2012 Jul 10. PMID: 22777251.
  • 17. Rosqvist K, Odin P, Hagell P, Iwarsson S, Nilsson MH, Storch A. Dopaminergic Effect on Non-Motor Symptoms in Late Stage Parkinson’s Disease. J Parkinsons Dis. 2018;8(3):409-420. doi: 10.3233/JPD-181380. Erratum in: J Parkinsons Dis. 2019;9(2):447-448. PMID: 30056433.
  • 18. Erro R, Picillo M, Vitale C, Amboni M, Moccia M, Longo K, et al. Non-motor symptoms in early Parkinson’s disease: A 2-year follow-up study on previously untreated patients. J Neurol Neurosurg Psychiatry. 2013 Jan;84(1):14- 7. doi: 10.1136/jnnp-2012-303419. Epub 2012 Sep 19. PMID: 22993448.
There are 18 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Articles
Authors

Sena Boncuk 0000-0002-0076-9405

Yeşim Güzey Aras 0000-0002-2000-8056

Early Pub Date March 15, 2024
Publication Date March 31, 2024
Submission Date April 8, 2023
Published in Issue Year 2024

Cite

AMA Boncuk S, Güzey Aras Y. Evaluation of the Frequency of Non-Motor Symptoms in Idiopathic Parkinson’s Disease by Gender and Disease Stage. Sakarya Tıp Dergisi. March 2024;14(1):47-53. doi:10.31832/smj.1273461

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