ABSTRACT
Background: Parkinson’s disease is a common neurodegenerative movement disorder characterised by motor symptoms of rest tremor, bradykinesia, rigidity and postural instability and non-motor symptoms (NMS) which include neuropsychiatric symptoms, sleep disturbances, autonomic symptoms, sensory symptoms and symptoms of mixed aetiology. Parkinson’s Disease Non Motor Group (PD-NMG) devised a comprehensive clinic-based self-completed NMS questionnaire that allows easy identification of NMS by the physician. Most NMS have a poor response to dopaminergic therapy as it is due to dysfunction of the serotonergic and noradrenergic pathways. Treatment of these nonmotor symptoms help in improving the quality of life in patients with Parkinson’s disease.Methods: There were 100 patients with Parkinson’s disease who had presented to our neuromedicine movement clinic were included in the study. Patients were diagnosed as PD based on UK Parkinson’s disease brain bank criteria. The inclusion criteria were diagnosis as PD, age >18 yrs, inclusion of both males and females and consent for the study. Patients with atypical parkinsonism and secondary parkinsonism, stroke, intake of antipsychotics were excluded from the study. Non motor symptom questionnaire was given to the study group and frequency of occurrence of each non motor symptoms and their predominance in both males and females were studied. The frequency of each NMS was calculated by computing the number of yes response and calculating the percentage related to the number of patients in the sample. Analysis was done to calculate the frequency of all NMS among the enrolled patient.Results: Nocturnal sleep disturbances (43%) were most common followed by constipation (29%).The most common non motor symptoms in males were constipation (20%), urinary urgency (18%) and nocturia (11%).The most common non motor symptoms in females were nocturnal sleep disturbance (25%), feeling sad (19%), unexplained pains (17%) and being anxious (13%).Conclusions: Non motor symptom questionnaire helps in screening patients with Parkinson’s disease of non-motor symptoms and aims at providing holistic treatment improving the quality of life.
ABSTRACT
BACKGROUND: The aim of this study was to determine the prevalence and characteristics of nonmotor symptoms (NMS)and alternative therapies (ATs) in Korean PD and to elucidate its association. METHODS: Demographic, social, and motor (Hoehn and Yahr stage; HY stage, motor section of Unified Parkinson Disease Rating Scale; mUPDRS) and NMS questionnaire were recorded in all PD patients (N=50) without significant cognitive impairment. RESULTS: Mean age and HY stage were 70.1 years and 2.3. Mean total numbers of positive NMS (tNMS) per patient was 12.9 and all patients had at least five NMS (range, 5-25). The most common items were nocturia (82%), constipation (70%) and memory disturbance (66%). Urinary (68%) domain was the most frequently involved. The tNMS was higher in female and in the group with higher mUPDRS score. Sleep and depression/anxiety domains were more involved in women. 63% of patients had experienced ATs and among them 29% of patients used ATs simultaneously. Health related food (32%), herbal medicine (32%), ginseng (32%) and acupuncture (23%) were the most commonly used. There was no association between ATs usage and demographic, social, motor and nonmotor characteristics. Among the ATs users, 20% of patients reported the effectiveness of ATs but the mean ATs costs was 12.4 fold higher than the medical costs. CONCLUSIONS: We suggest that mean tNMS is higher in Korean PD patients comparing with other previous studies. Women might be more vulnerable to NMS than men expecially in sleep and depression/anxiety. We couldn't found the associated between usage of ATs and clinical variables including NMS.