FM2-3 Slave to the rhythm: seasonal differences in non-motor symptoms in parkinson’s

ObjectivesTo determine the effect of the change of season on non-motor symptoms in Parkinson’s disease (PD).DesignCross-sectional retrospective study.Subjects364 consecutive Parkinson’s patients in the London area taking part in the Non-motor Longitudinal International Study (NILS) study at King’s College Hospital London between November 2011 and April 2018.MethodsParticipants were divided into three groups based on their assessment date, using a simplified ecological seasonal model:November until February;March until 15 June;16 June until October.The primary outcome was a seasonal difference in non-motor symptom scale (NMSS) total scores and the secondary outcomes were NMSS subscores. Outcomes were adjusted for multiple testing using formal Bonferroni correction.Results102 patients were allocated to group 1, 105 patients to group 2 and 157 patients to group 3. Seasonal differences were present in NMSS total scores (p=0.042), especially between groups 1 and 3 (p=0.037). Differences were also present for NMSS domain 1 (cardiovascular and falls; p=0.004), 2 (sleep and fatigue; p=0.049), 4 (hallucinations; p=0.003) and 9 (miscellaneous; p=0.031). Within domain 9 there was only a significant difference for question 28 (smell; p=0.008).ConclusionsThese results indicate that non-motor symptoms in Parkinson’s fluctuate throughout the year with lowest scores in the summer months and highest in the winter months. These variations need to be taken into account to avoid inappropriate changes in medication regimes.

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The Cold Hand Sign in Multiple System Atrophy: Frequency-Associated Factors and Its Impact on Survival

Frontiers in Aging Neuroscience ◽

10.3389/fnagi.2021.767211 ◽

2021 ◽

Vol 13 ◽

Author(s):

Bei Cao ◽

Yan Liang ◽

Ling-Yu Zhang ◽

Yan-Bing Hou ◽

Ru-Wei Ou ◽

...

Keyword(s):

Multiple System Atrophy ◽

Disease Duration ◽

Rating Scale ◽

Age At Onset ◽

Motor Symptom ◽

Motor Symptoms ◽

Symptom Scale ◽

The Impact ◽

Early Occurrence ◽

Non Motor Symptoms

Background: Few studies have focused on the cold hand sign (CHS), a red flag symptom, in multiple system atrophy (MSA).Objective: This study aimed to investigate the frequency and correlative factors of CHS in patients with MSA and the impact of its early occurrence on the survival of these patients.Methods: A total of 483 patients with MSA were enrolled in this study, and the motor and non-motor symptoms between patients with MSA with and without CHS were compared. Moreover, patients with disease duration ≤ 3 years at baseline were followed, and the association between CHS and survival of patients with MSA was examined.Results: The frequencies of CHS in patients with MSA were 20, 15.4, and 25.3% in MSA, MSA-parkinsonian subtype (MSA-P), and MSA-cerebellar subtype (MSA-C), respectively. Higher Unified Multiple System Atrophy Rating Scale (UMSARS) scores and higher Non-Motor Symptom Scale (NMSS) scores at baseline were associated with CHS in MSA. CHS was associated with shorter survival after adjusting for baseline diagnosis subtype, age at onset, sex, orthostatic hypotension, disease duration, autonomic onset, UMSARS total score, and NMSS score (p = 0.001; HR = 3.701; 95% CI = 1.765–7.760).Conclusion: CHS is not rare in patients with MSA. Greater disease severity and more severe non-motor symptoms were associated with CHS in patients with MSA. Patients with early occurrence of CHS had a poor prognosis.

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FM2-2 Exploratory analysis whether wearable sensor data can correlate with aspects of non-motor symptoms in parkinson’s: a real life study with the parkinson’s kinetigraphTM

Journal of Neurology Neurosurgery & Psychiatry ◽

10.1136/jnnp-2019-abn.75 ◽

2019 ◽

Vol 90 (3) ◽

pp. e24.1-e24 ◽

Cited By ~ 1

Author(s):

S Hota ◽

A Podlewska ◽

A Rizos ◽

DV Wamelen ◽

K Chaudhuri

Keyword(s):

Gastrointestinal Tract ◽

Real Life ◽

International Study ◽

Sensor Data ◽

Motor Symptoms ◽

College Hospital ◽

Cross Sectional ◽

Gastrointestinal Problems ◽

Motor Effects ◽

Non Motor Symptoms

ObjectivesTo determine the association between the range and nature of non-motor symptoms (NMS) in people with Parkinson’s (PwP) and validated Parkinson’s KinetigraphTM (PKG) outcome measures.DesignCross-sectional retrospective study of participants enrolled in the Non-motor Longitudinal International Study (NILS, UKCRN No: 10084) at King’s College Hospital, London.Subjects108 PwP with a PKG recording within 4 months of a NILS assessment were included in the analysis.MethodsPKG is a validated accelerometery-based measure for motor function in PwP, reporting scores for global bradykinesia (BKS) and dyskinesia (DKS). NMS were assessed by the NMS scale (NMSS).ResultsUsing multiple linear regression, BKS was predicted by NMSS domains 6 (gastrointestinal tract; p=0.006) and 8 (sexual function; p=0.003). DKS was predicted by domains 3 (mood/cognition; p=0.016), domain 4 (perceptual problems; p=0.025), domain 6 (gastrointestinal tract; p=0.029) and domain 9 (miscellaneous, p=0.003). In these domains, anxiety, delusions, dysphagia, hyposmia, weight change and hyperhidrosis significantly predicted DKS. In addition, carbidopa dose predicted NMSS total scores (p=0.037), but not total LEDD (p=0.91).ConclusionsIn PwP, measures of BK and DK were mainly associated with gastrointestinal problems, underpinning the importance of gastric absorption of oral medications and constipation and the related motor effects in PwP. Interestingly, carbidopa appears to have a role in non-motor symptoms in PwP, which deserves further investigation.

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A Dual Centre Study of Pain in Parkinson’s Disease and Its Relationship with Other Non-Motor Symptoms

Journal of Parkinson s Disease ◽

10.3233/jpd-202088 ◽

2020 ◽

Vol 10 (4) ◽

pp. 1817-1825

Author(s):

Pritha Ghosh ◽

Paola Imbriani ◽

Nicoletta Caputi ◽

Silvia Natoli ◽

Tommaso Schirinzi ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Rating Scale ◽

Clustering Algorithms ◽

Motor Symptom ◽

Sleep Disruption ◽

Motor Symptoms ◽

Cross Sectional ◽

Non Motor Symptoms ◽

Updrs Part

Background: Pain is a disabling and often underestimated non-motor symptom (NMS) detrimentally affecting the quality of life of patients with Parkinson’s disease (PD). Objective: Here, we conducted a cross-sectional, observational international study on 167 patients with idiopathic PD in order to analyze the potential relationship between pain and other NMS. Methods: Subjects were assessed with the Unified Parkinson’s Disease Rating Scale (UPDRS) part III, Hoehn and Yahr (H&Y) stage, King’s Parkinson’s Disease Pain Scale (KPPS), Brief Pain Inventory (BPI), Non-Motor Symptoms Scale (NMSS), and Beck Depression Inventory (BDI). Spearman’s rank correlation coefficient, multiple regression and multiple index-based clustering algorithms were used for data analysis. Results: The prevalence of pain was 88.6%, was not correlated with age, motor severity (UPDRS part III) or disease duration, whereas a weak correlation with female gender and H&Y stage >2.5 was found. Multiple NMS correlated significantly with pain. Specifically, sleep disturbance had the strongest correlation with pain, followed by depression, gastrointestinal and cardiovascular disturbances. Further analyses showed that sleep and cardiovascular disturbance were independently associated with pain, and that these symptoms clustered together in a subset of PD patients. The relationship between pain, sleep and dysautonomia persisted independently from dopamine replacement therapy. Conclusion: Our study suggests that sleep disruption and cardiovascular disturbance are associated with pain in PD, and possibly identifies a specific subtype within PD patients with pain. Our data also indicate that sleep disruption, pain and dysautonomia may have a common pathophysiology, possibly involving non-dopaminergic pathways.

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Autonomic Symptoms Correlate with Non-Autonomic Non-Motor Symptoms and Sleep Problems in Patients with Parkinson’s Disease

European Neurology ◽

10.1159/000495797 ◽

2018 ◽

Vol 80 (3-4) ◽

pp. 193-199 ◽

Cited By ~ 9

Author(s):

Takeo Matsubara ◽

Keisuke Suzuki ◽

Hiroaki Fujita ◽

Yuji Watanabe ◽

Hirotaka Sakuramoto ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Sleep Problems ◽

Linear Regression Analysis ◽

Motor Symptom ◽

Motor Symptoms ◽

Symptom Scale ◽

Autonomic Symptoms ◽

Dat Scan ◽

Non Motor Symptoms

Objective: The objective of this study was to clarify the relationship between autonomic and non-autonomic non-motor symptoms in patients with Parkinson’s disease (PD). Methods: Sixty-five PD patients were included in this study (27 men and 38 women; aged 68.5 ± 10.0; Hoehn and Yahr (HY) stage 2.6 ± 1.1). The autonomic symptoms were evaluated by the Japanese version of the Scales for outcomes in PD autonomic (SCOPA-AUT) questionnaire. The patients were assessed with the mini-mental state examination (MMSE), PD sleep evaluation scale-2 (PDSS-2), Epworth sleepiness scale (ESS) and Beck’s depression inventory II (BDI-II). The Non-Motor Symptom Scale (NMSS) total scores and subscores of non-autonomic non-motor symptom domains (sleep/fatigue, mood/cognition, perceptual problems/hallucination, and attention/memory) were evaluated. A dopamine transporter (DAT) scan, metaiodobenzylguanidine (MIBG) myocardial scintigraphy, and card type olfactory identification test (open essence [OE, Wako]) were performed. Results: The SCOPA-AUT total score was positively correlated with the disease duration, HY stage, levodopa equivalent dose, PDSS-2, ESS, BDI-II and non-autonomic NMSS and inversely correlated with the MMSE. The high-SCOPA-AUT group (≥9) had lower MMSE scores and higher PDSS-2, ESS, BDI-II and non-motor NMSS scores than the low-SCOPA-AUT group (< 9). The DAT scan, MIBG uptake and OE score did not differ between the groups. In a stepwise linear regression analysis, which excluded possibly overlapping items among the scales, the subtotals of PDSS-2 items, except for item 8 (nocturia), (p < 0.0001) and non-autonomic NMSS domains (p = 0.00040) were significant predictors of the total SCOPA-AUT score. Conclusion: Our study shows significant correlations among autonomic symptoms, PD-related sleep problems and non-autonomic non-motor symptoms in PD patients.

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A systematic review of non-motor symptom evaluation in clinical trials for amyotrophic lateral sclerosis

Journal of Neurology ◽

10.1007/s00415-021-10651-1 ◽

2021 ◽

Author(s):

Emily Beswick ◽

Deborah Forbes ◽

Zack Hassan ◽

Charis Wong ◽

Judith Newton ◽

...

Keyword(s):

Clinical Trials ◽

Amyotrophic Lateral Sclerosis ◽

Sleep Disturbances ◽

Neuropsychiatric Symptoms ◽

Behavioural Change ◽

Motor Symptom ◽

Motor Symptoms ◽

Behavioural Changes ◽

Non Motor Symptoms ◽

Lateral Sclerosis

Abstract Background Amyotrophic lateral sclerosis (ALS) is increasingly recognised as a multi-system disorder, presenting with common and impactful non-motor symptoms, such as neuropsychiatric symtpoms, cognitive and behavioural changes, pain, disordered sleep, fatigue and problematic saliva. Aim/hypothesis We aimed to systematically review 25 years of ALS clinical trials data to identify if non-motor features were evaluated, in addition to the traditional measures of motor functioning and survival, and where evaluated to describe the instruments used to assess. We hypothesised that assessment of non-motor symptoms has been largely neglected in trial design and not evaluated with ALS-suitable instruments. Methods We reviewed clinical trials of investigative medicinal products in ALS, since the licensing of riluzole in 1994. Trial registry databases including WHO International Trials Registry, European Clinical Trials Register, clinicaltrials.gov, and PubMed were systematically searched for Phase II, III or IV trials registered, completed or published between 01/01/1994 and 16/09/2020. No language restrictions were applied. Results 237 clinical trials, including over 29,222 participants, were investigated for their use of non-motor outcome measures. These trials evaluated neuropsychiatric symptoms (75, 32%), cognitive impairment (16, 6.8%), behavioural change (34, 14%), pain (55, 23%), sleep disturbances (12, 5%) and fatigue (18, 8%). Problematic saliva was assessed as part of composite ALS-FRS(R) scores in 184 trials (78%) but with no focus on this as an isolated symptom. 31 (13%) trials including 3585 participants did not include any assessment of non-motor symptoms. Conclusions Non-motor symptoms such as neuropsychiatric, cognitive and behavioural changes, pain, disordered sleep, fatigue, and problematic saliva have not been consistently evaluated in trials for people with ALS. Where evaluated, non-symptoms were primarily assessed using instruments and impairment thresholds that are not adapted for people with ALS. Future trials should include non-motor symptom assessments to evaluate the additional potential therapeutic benefit of candidate drugs. PROPSERO registration CRD42020223648.

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Parkinson Disease: The Relationship Between Non-motor Symptoms and Motor Phenotype

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/cjn.2015.328 ◽

2015 ◽

Vol 43 (2) ◽

pp. 261-267 ◽

Cited By ~ 23

Author(s):

Fang Ba ◽

Mona Obaid ◽

Marguerite Wieler ◽

Richard Camicioli ◽

W.R. Wayne Martin

Keyword(s):

Parkinson Disease ◽

Rating Scales ◽

Advanced Disease ◽

Axial Component ◽

Motor Symptoms ◽

Linear Regression Models ◽

Cross Sectional ◽

The Relationship ◽

Non Motor Symptoms ◽

Motor Phenotype

AbstractBackground: Parkinson disease (PD) presents with motor and non-motor symptoms (NMS). The NMS often precede the onset of motor symptoms, but may progress throughout the disease course. Tremor dominant, postural instability gait difficulty (PIGD), and indeterminate phenotypes can be distinguished using Unified PD Rating scales (UPDRS-III). We hypothesized that the PIGD phenotype would be more likely to develop NMS, and that the non-dopamine–responsive axial signs would correlate with NMS severity. Methods: We conducted a retrospective cross-sectional chart review to assess the relationship between NMS and PD motor phenotypes. PD patients were administered the NMS Questionnaire, the UPDRS-III, and the Mini-Mental State Examination score. The relationship between NMS burden and PD subtypes was examined using linear regression models. The prevalence of each NMS among difference PD motor subtypes was analyzed using chi-square test. Results: PD patients with more advanced disease based on their UPDRS-III had higher NMS Questionnaire scores. The axial component of UPDRS-III correlated with higher NMS. There was no correlation between NMS and tremor scores. There was a significant correlation between PIGD score and higher NMS burden. PIGD group had higher prevalence in most NMS domains when compared with tremor dominant and indeterminate groups independent of disease duration and severity. Conclusions: NMS profile and severity vary according to motor phenotype. We conclude that in the PD population, patients with a PIGD phenotype who have more axial involvement, associated with advanced disease and poor motor response, have a higher risk for a higher NMS burden.

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Occupational Stress among Nurses in a Public Medical College Hospital

Delta Medical College Journal ◽

10.3329/dmcj.v6i2.38218 ◽

2018 ◽

Vol 6 (2) ◽

pp. 86-89

Author(s):

Shila Rani Das ◽

Chinmay Biswas ◽

Sharmina Afrin

Keyword(s):

Occupational Stress ◽

Family Income ◽

High Stress ◽

Clinical Work ◽

Medical College Hospital ◽

College Hospital ◽

Cross Sectional ◽

Medical College ◽

Work Related ◽

Significant Difference

Background: Now a days, there is increased demand and progress in the nursing profession. Along with these stress among the nurses has also increased.Objective: Purpose of the study was to assess the extent of perceived occupational stress and its association with work-related and non-work related causes among nurses.Materials and method: This Cross-sectional study was carried out among 197 nurses of Shaheed Suhrawardy Medical College hospital (ShSMCH), Dhaka, Bangladesh, from the period of 1st July 2015 to 30th June 2016. Sampling method was simple random sampling. Data was collected by face to face interview with the help of semi-structured questionnaire and finally all data were analyzed using SPSS software version 21.Results: It was found that 69% nurses were between the age of 21 to 39 years, 94.9% were female, 68% were married, 79.2% were Muslim, 84.3% had diploma, family income of 91.4% were equal to more than 40,000 Tk. and 95.5% used to do clinical work. Only 5.1% found to experience high stress. Statistically significant difference was found between sex, occupational stress and religion, educational status, and type of work (p < 0.05). Few nurses suffered from high stress but high level of stress were more in male, non Muslim, post graduate nurse and those who were engaged in administrative work.Conclusion: Nurse Managers should take appropriate actions to decrease stress helping their nurses to work efficiently and effectively.Delta Med Col J. Jan 2018 6(2): 86-89

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FAKTOR-FAKTOR YANG MEMPENGARUHI SUBTIPE GEJALA MOTORIK PENYAKIT PARKINSON

Human Care Journal ◽

10.32883/hcj.v5i1.649 ◽

2020 ◽

Vol 5 (1) ◽

pp. 343

Author(s):

Attiya Istarini ◽

Yuliarni Syafrita ◽

Restu Susanti

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Age At Onset ◽

Motor Symptom ◽

Disease Stage ◽

Motor Symptoms ◽

Research Subjects ◽

Cross Sectional ◽

Duration Of Disease ◽

Cross Sectional Design

Background: Parkinson's disease (PD) is a chronic neurodegenerative disease that manifests as movement disorders. Based on motor symptoms, PD is classified into subtypes of tremor and postural instability gait disorders (PIGD). The motor symptoms subtype is a predictor of disease progression, therapeutic response, and quality of life for Parkinson's patients. The purpose of this study is to identify some factors that influence motor symptoms in Parkinson's disease.Methods: This research use cross sectional design. Samples were selected by consecutive sampling method that met the inclusion and exclusion criteria. Research subjects were 58 people. Statistical analysis using SPSS. p values <0.05 were considered statistically significant.Results: This research include 58 patients, 55.2% were men with range of age 63.5 ± 8.5 years old. The mean age at onset was 57.9 ± 9.5 years and duration of disease 6.1 ± 4.6 years. Motor symptoms 53.4% dominant tremor. There was a significant relationship between disease stage and motor symptom subtypes (p <0.001). There is no relationship between the patient's age, age at onset and duration of the disease with motor symptom subtypes.Conclusions: There is a relationship between disease stage and motor symptom. The patient's age, age at onset and duration of the disease are not related to the motor symptoms of Parkinson's patients.

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