scholarly journals Characteristics of Autonomic Dysfunction in Parkinson’s Disease: A Large Chinese Multicenter Cohort Study

2021 ◽  
Vol 13 ◽  
Author(s):  
Zhou Zhou ◽  
Xiaoting Zhou ◽  
Xiaoxia Zhou ◽  
Yaqin Xiang ◽  
Liping Zhu ◽  
...  

Autonomic dysfunction (AutD) is one of the non-motor symptoms (NMSs) in Parkinson’s disease (PD). To investigate the prevalence and clinical features of AutD in Chinese patients with PD, a large multicenter cohort of 2,556 individuals with PD were consecutively involved in the Parkinson’s Disease and Movement Disorders Multicenter Database and Collaborative Network in China (PD-MDCNC) between January 1, 2017, and December 31, 2019. The assessment of AutD was performed using the Scale for Outcomes in Parkinson’s Disease for Autonomic Symptoms (SCOPA-AUT). The evaluation of motor symptoms and other NMSs were performed using well-established scales recommended by the Movement Disorder Society. We found that out of 2,556 patients with PD, 2,333 patients with PD (91.28%) had AutD. Compared with the group of patients with PD without AutD, the group of patients with PD with AutD had older age, older age of onset, longer disease duration, more severe motor symptoms, motor complications, and more frequent NMSs. As for partial correlation analysis, the total SCOPA-AUT score was significantly and positively associated with motor severity scales [Unified Parkinson’s Disease Rating Scale (UPDRS) total score] and some of the NMSs [Rapid Eye Movement Sleep Behavior Disorder Questionnaire (RBD), Epworth Sleepiness Scale, Hamilton Depression Scale], Fatigue Severity Scale, and Parkinson’s disease questionnaire. PD Sleep Scale was significantly and negatively correlated with AutD. With logistic regression analysis for potentially related factors, age, UPDRS total score, RBD, hyposmia, depression, and fatigue may be associated with PD with AutD. In conclusion, our multicenter cohort study reported the high prevalence of AutD in Chinese PD and revealed the associated factors of PD with AutD.

2021 ◽  
Vol 12 ◽  
Author(s):  
Yiwei Qian ◽  
Yi Zhang ◽  
Xiaoqin He ◽  
Shaoqing Xu ◽  
Xiaodong Yang ◽  
...  

Social media listening (SML) is a new process for obtaining information from social media platforms to generate insights into users' experiences and has been used to analyze discussions about a multitude of diseases. To understand Parkinson's disease patients' unmet needs and optimize communication between doctors and patients, social media listening was performed to investigate concerns in Chinese patients. A comprehensive search of publicly available social media platforms with Chinese-language content posted between January 2005 and April 2019 in mainland China was performed using defined Parkinson's disease-related terms. After multiple steps of machine screening were performed, a series of posts were derived. The content was summarized and classified manually to analyze and map psychological insights, and descriptive statistics were applied to aggregate findings. A total of 101,899 patient-related posts formed the basis of this study. The topics mainly focused on motor symptoms (n = 54,983), choice of pharmaceutical drugs (n = 45,203) and non-motor symptoms (n = 44,855). The most common symptoms mentioned were tremor (54.5%), pain (22.9%), and rigidity (22.1%). Psychological burden (51%) and work/social burden (48%) were the most concerning burdens for patients and their families. The compound levodopa (43%) and dopamine agonists (23%) were the most common options for the patients, while concerns about new-generation anti-Parkinson's disease medication increased. The portraits of patients suggested varying characteristics across different periods and advocate for personalized service from doctors. In the management of patients, it is imperative to plan individualized therapy and education strategies as well as strategies for social support.


2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Ruwei Ou ◽  
Yanbing Hou ◽  
Qianqian Wei ◽  
Junyu Lin ◽  
Kuncheng Liu ◽  
...  

AbstractThe progression of global non-motor symptoms (NMS) in Chinese patients with Parkinson’s disease (PD) has not been explored. We aimed to examine the longitudinal evolution of overall NMS in a 3-year prospective Chinese cohort with early-stage PD. We included 224 patients with early PD who underwent annual evaluation of motor and non-motor symptoms. NMS was assessed using the non-motor symptoms scale (NMSS). We observed an increased number of NMS in the majority of the NMSS domains except mood/apathy and sexual dysfunctions. Significant deterioration was observed in the sleep/fatigue, perceptual problems/hallucinations, attention/memory, gastrointestinal, urinary, and miscellaneous domains during the follow-up (P < 0.05). Notably, the number and the score of sexual dysfunctions decreased with the progression of the disease. All NMSS domains showed a small effect size from baseline to 1-, 2-, and 3-year follow-ups (effect size < 0.5). The generalized estimating equations model indicated that the total number of NMS was significantly associated with age and the Unified Parkinson’s Disease Rating Scale (UPDRS) III score (P < 0.05). Multiple logistic regression indicated that a high number of NMS at baseline was associated with a 3-point, a 6-point, and a 9-point increase in the UPDRS III score from baseline to 1-year (odds ratio [OR] 1.074, P = 0.017), 2-year (OR 1.113, P = 0.001), and 3-year (OR 1.117, P < 0.001), respectively. Our study indicated that overall NMS evolution in early PD is mild and multidimensional; a high NMS burden in early PD predicts the faster motor progression of PD. Our study is helpful for understanding the longitudinal evolution of NMS in PD.


2015 ◽  
Vol 21 (6) ◽  
pp. 610-614 ◽  
Author(s):  
Wei Chen ◽  
Wen-Yan Kang ◽  
Shuai Chen ◽  
Ying Wang ◽  
Qin Xiao ◽  
...  

2021 ◽  
Vol 12 ◽  
Author(s):  
Sha Zhu ◽  
Min Zhong ◽  
Yu Bai ◽  
Zhuang Wu ◽  
Ruxin Gu ◽  
...  

Background and Purpose: The unilateral onset and persistent asymmetry of motor symptoms are important characteristics of Parkinson's disease (PD). By using scales and wearable sensors, this study explored whether motor symptom laterality could affect non-motor symptom and gait performance.Methods: A total of 130 right-handed patients with PD were enrolled in our study and were divided into two groups according to the side of predominant motor symptom presentation by using the Unified Parkinson's Disease Rating Scale part III. We measured the non-motor symptoms with the Non-motor symptoms Scale, sleep quality with the Parkinson's Disease Sleep Scale and Pittsburgh sleep quality index, cognitive function with the Mini-mental State Examination and Montreal Cognitive Assessment, quality of life with the Parkinson's Disease Questionnaire-39, and the severity of anxiety and depression with the Hamilton Anxiety Scale and Hamilton Depression Scale, respectively. All participants underwent the instrumented stand and walk test, and gait data were collected using a set of JiBuEn gait analysis system.Results: We observed that left-dominant symptom PD patients (LPD) were associated with a greater impairment of sleep quality than right-dominant symptom PD patients (RPD). We found no difference between LPD and RPD in terms of gait performance. However, compared with the severe asymmetry RPD patients (RPD-S), severe asymmetry LPD patients (LPD-S) showed a shorter stride length and decreased range of motion of hip joints.Conclusions: In this study, LPD was associated with a more severe sleep-related dysfunction than RPD. In addition, LPD-S exhibited more gait impairments than RPD-S. Considering that motor symptom laterality may affect the non-motor symptom and gait performance, it should be taken into account when evaluating and treating PD patients.


BMC Neurology ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Jeffrey M. Boertien ◽  
◽  
Sygrid van der Zee ◽  
Asterios Chrysou ◽  
Marleen J. J. Gerritsen ◽  
...  

Abstract Background Parkinson’s Disease (PD) is a heterogeneous, progressive neurodegenerative disorder which is characterized by a variety of motor and non-motor symptoms. To date, no disease modifying treatment for PD exists. Here, the study protocol of the Dutch Parkinson Cohort (DUPARC) is described. DUPARC is a longitudinal cohort study aimed at deeply phenotyping de novo PD patients who are treatment-naïve at baseline, to discover and validate biomarkers for PD progression, subtypes and pathophysiology. Methods/design DUPARC is a prospective cohort study in which 150 de novo PD subjects will be recruited through a collaborative network of PD treating neurologists in the northern part of the Netherlands (Parkinson Platform Northern Netherlands, PPNN). Participants will receive follow-up assessments after 1 year and 3 years, with the intention of an extended follow-up with 3 year intervals. Subjects are extensively characterized to primarily assess objectives within three major domains of PD: cognition, gastrointestinal function and vision. This includes brain magnetic resonance imaging (MRI); brain cholinergic PET-imaging with fluoroethoxybenzovesamicol (FEOBV-PET); brain dopaminergic PET-imaging with fluorodopa (FDOPA-PET); detailed neuropsychological assessments, covering all cognitive domains; gut microbiome composition; intestinal wall permeability; optical coherence tomography (OCT); genotyping; motor and non-motor symptoms; overall clinical status and lifestyle factors, including a dietary assessment; storage of blood and feces for additional analyses of inflammation and metabolic parameters. Since the start of the inclusion, at the end of 2017, over 100 PD subjects with a confirmed dopaminergic deficit on FDOPA-PET have been included. Discussion DUPARC is the first study to combine data within, but not limited to, the non-motor domains of cognition, gastrointestinal function and vision in PD subjects over time. As a de novo PD cohort, with treatment naïve subjects at baseline, DUPARC provides a unique opportunity for biomarker discovery and validation without the possible confounding influences of dopaminergic medication. Trial registration NCT04180865; registered retrospectively, November 28th 2019.


2017 ◽  
Vol 33 (3) ◽  
pp. 391-397 ◽  
Author(s):  
Aristide Merola ◽  
Alberto Romagnolo ◽  
Michela Rosso ◽  
Ritika Suri ◽  
Zoe Berndt ◽  
...  

2021 ◽  
Vol 10 (9) ◽  
pp. 1824
Author(s):  
Eduardo Candel-Parra ◽  
María Pilar Córcoles-Jiménez ◽  
Victoria Delicado-Useros ◽  
Antonio Hernández-Martínez ◽  
Milagros Molina-Alarcón

Parkinson’s disease (PD) is a chronic neurodegenerative disorder that results in important functional symptoms, altered mood, and deterioration in quality of life (QoL). This study aimed to determine the evolution of the QoL in persons with PD in the Albacete health district over a two-year period and identify associated sociodemographic, clinical, and socio-health characteristics. A cohort study was conducted of patients at different stages of PD in the Albacete health district. Calculated sample size: 155 patients. Instruments: A purpose-designed questionnaire for data collection and the “Parkinson Disease Questionnaire” (PDQ-39), which measures 8 dimensions and a global index where a higher score indicates worse quality of life. Three measurements were made: baseline, one year, two years. A descriptive and bivariate analysis was conducted. Ethical aspects: informed consent, anonymized data. Results: Mean age 69.51 (standard deviation, SD 8.73) years, 60% male, 75.5% married, and 85.5% lived with family. The most frequent motor symptoms were slow movement (86.23%), postural instability (55.5%), tremor (45.5%), and dyskinesia (24.6%). Among the non-motor symptoms were fatigue (66.2%), pain, daytime somnolence, constipation, and apathy, with approximately 50% each. The mean QoL score at baseline was 27.47 (SD 16.14); 95% CI (confidence interval) 24.91–30.03. At two years, global QoL had slightly worsened (28.3; SD 17.26; 95% CI 25.41–31.18), with a statistically significant worsening in mobility, activities of daily living, and communication, whereas social support improved.


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