Most Untreated Parkinson’s Patients Have Non-Motor Symptoms, Study Shows
Non-motor symptoms are common among patients with Parkinson’s disease who have not yet received any treatment, and the type of symptoms differs between men and women and onset age groups, a study shows.
The study, “Gender and onset age related-differences of non-motor symptoms and quality of life in drug-naïve Parkinson’s disease,” was published in the journal Clinical Neurology and Neurosurgery.
Parkinson’s disease is mostly recognized by its motor symptoms, such as tremor and postural instability. Several non-motor symptoms, including sleep disorders, neuropsychiatric disturbances, and sensory deficits, have also been reported in Parkinson’s patients at both the early and late stages of the disease.
Increasing evidence suggests that these non-motor symptoms can precede the onset of Parkinson’s motor manifestations and have a significant impact on patients’ quality of life.
Studies addressing the prevalence and nature of Parkinson’s non-motor symptoms have been widely discussed in the general Parkinson’s population, mainly in patients receiving anti-parkinsonian therapy. However, the presence of non-motor symptoms may be confounded by the fact that many of these symptoms arise as part of therapy-related side effects.
In this study, a team of researchers evaluated the prevalence of non-motor symptoms in 569 Chinese patients with Parkinson’s disease who had not yet been treated with any approved therapy.
“Untreated PD [Parkinson’s disease] patients represent a suitable model, which is good for exploring the clinical expression of NMS [non-motor symptoms] as well as motor symptoms,” the researchers wrote.
The team wanted to explore the gender and onset age-related non-motor symptom profiles and investigate the determinants of quality of life in these patients.
Participants were between the ages of 45 and 70 and had a mean disease duration of two years. Approximately 51.7% were women, 18.6% had early-onset disease, and overall patients showed bilateral disease without impairment of balance, as determined by a score of 1.9 on the modified Hoehn and Yahr (H&Y) staging scale.
The mean score on the Unified Parkinson’s Disease Rating Scale (UPDRS III), which assesses the motor signs of Parkinson’s disease, was 21.7, with men exhibiting significantly higher (worse) scores than females.
A total of 552 patients had at least one Parkinson’s non-motor symptom, with 74% reporting sleep disorder or fatigue and 62.7% attention or memory impairments. The rarest manifestation was perceptual problems or hallucinations, which affected 3.7% of patients.
Men showed a higher incidence of urinary and sexual dysfunction, and a significantly lower incidence of sleep issues or fatigue, mood changes or apathy, and attention or memory impairments than women.
The team also found that patients with late-onset disease had a significantly higher incidence of perceptual problems or hallucinations, attention or memory deficits, as well as gastrointestinal, urinary, and sexual dysfunctions than early-onset Parkinson’s patients.
Overall, patients who were depressed and those who had worse non-motor symptoms, in particular sleep problems or fatigue, mood alterations or apathy, attention or memory impairments, or gastrointestinal symptoms, were found to have a poorer quality of life.
“Our study suggests that NMS is common in drug-naïve PD patients,” the researchers wrote.
“NMS, especially sleep/ fatigue, mood/apathy, attention/memory, and gastrointestinal symptoms, are dramatic determinants on decreased QoL [quality of life] in PD patients,” they added. “Management of non-motor symptoms is of great importance to improve the quality of life of early stage Parkinson’s disease patients.”