Frequency of non-motor symptoms and their impact on the quality of life in patients with Parkinson's disease: a prospective descriptive case series.

AIM: In this study, we aimed to show non-motor symptoms (NMS), in addition to motor symptoms, in the foreground of idiopathic Parkinson's disease (IPD). We also examined the prevalence of dopamine dysregulation syndrome, which can be evaluated based on NMS, its risk factors, and its effects on quality of life (QOL) by using various scales and questionnaires. METHODS: In total, 75 patients with IPD (46 men, 29 women) who attend the outpatient neurology clinic of our hospital were included in the study. The motor symptoms and NMS of IPD were examined. The severity of parkinsonism was evaluated with the Unified Parkinson's Disease Rating Scale and the Hoehn and Yahr scale. Cognitive tests, the NMS questionnaire, the Parkinson's Disease Sleep Scale, and the Dopamine Dysregulation Syndrome-Patient and Caregiver Inventory were used to identify NMS. The 39-item Parkinson's Disease Questionnaire evaluated QOL. RESULTS: We observed a significant increase in scores on the tests assessing NMS, specifically the Parkinson's Disease Questionnaire, NMS questionnaire, Parkinson's Disease Sleep Scale, and Geriatric Depression Scale (P < 0.05). These increases correlated with an increase in the Unified Parkinson's Disease Rating Scale score and a stage increase on the Hoehn and Yahr scale. Based on the scores, motor severity most affected QOL. CONCLUSION: Ignoring NMS while focusing primary on motor symptoms in IPD can cause serious insufficiencies in treatment plans. Assessing NMS and dopamine dysregulation syndrome with structured scales that employ an integrated approach can improve QOL in IPD.

Pathophysiology underlying drooling in Parkinson's disease: oropharyngeal bradykinesia.

We aimed to investigate the association between drooling and possible etiological factors in Parkinson's disease (PD) and to determine its effect on the quality of life. Demographic data of the 63 patients with idiopathic PD were recorded. Radboud Oral Motor Inventory for Parkinson's disease (ROMP) test was administered to all patients to evaluate speech, swallowing functions, and saliva control. The freezing of gait questionnaire (FOGQ) was used to evaluate gait and freezing of gait. Dynamic Parkinson gait scale (DYPAGS) was administered for the objective quantification of PD gait features. Disease severity was assessed by UPDRS and modified Hoehn & Yahr Scale. PD specific health-related quality was evaluated by PDQ-39 questionnaire. Drooling was only significantly correlated to UPDRS score; a stronger association was found between drooling and UPDRS 3 motor score; and a more significant association was determined between drooling and the bradykinesia questions of the motor part of UPDRS 3. Interestingly, no significant association was found between sialorrhea score and PDQ-39 score. Based on the results of this study, we concluded that oropharyngeal bradykinesia may be responsible for drooling in PD. In contrast to a general expectation, we did not find any adverse impact of drooling on the quality of life.

Elevated interictal serum HSP-70 levels as an indicator of neurodegeneration for chronic migraine.

OBJECTIVE: To investigate whether there is a relationship between chronic migraine and heat shock protein-70. METHODS: The case-control progressive study was conducted at Ankara Numune Teaching and Research Hospital, Ankara, Turkey, from January to June 2013, and comprised patients over 18 years of age who were diagnosed with chronic migraine and did not have any other known neurological illness. Age and gender-matched volunteers with no history of headache or neurological illness were included as controls. In order to exclude other central nervous system diseases, computed tomography and/or magnetic resonance imaging was carried out. Blood samples to evaluate serum heat shock protein-70 levels were obtained from the patients during headache-free periods and from the controls following 8 hours of fasting. The samples were interpreted using the enzyme-linked immunosorbent assay reader. RESULTS: There were 40 controls and an equal number of cases in the study. Mean heat shock protein-70 levels were higher in the cases 2.37±1.91ng/dl compared to thecontrols1.81±1.30 ng/dl, but the difference was not statistically significant (p=0.12). Serum heat shock protein-70 levels were also compared in terms of the duration of migraine disease, frequency of migraine attacks, Visual Analogue Scale score, migraine attack duration and the presence of aura, but no statistically significant difference was found (p=0.13, p=0.17, p=0.90, p=0.68, p=0.95 respectively). CONCLUSIONS: Heat shock protein-70 was not a reliable chronic migraine biomarker.