Abstract
Growing evidence suggests that non-motor symptoms (NMS) in Parkinson’s disease (PD) have differential progression patterns that have a different natural history from motor progression and may be geographically influenced. We conducted a cross-sectional analysis of 1607 PD patients of whom 1327 were from Europe, 208 from the Americas, and 72 from Asia. The primary objective was to assess baseline non-motor burden, defined by Non-Motor Symptoms Scale (NMSS) total scores. Other aims included identifying the factors predicting quality of life, differences in non-motor burden between drug-naïve and non-drug-naïve treated patients, and non-motor phenotypes across different geographical locations. Mean age was 65.9 ± 10.8 years, mean disease duration 6.3 ± 5.6 years, median Hoehn and Yahr stage was 2 (2–3), and 64.2% were male. In this cohort, mean NMSS scores were 46.7 ± 37.2. Differences in non-motor burden and patterns differed significantly between drug-naïve participants, those with a disease duration of less than five years, and those with a duration of five years or over (p ≤ 0.018). Significant differences were observed in geographical distribution (NMSS Europe: 46.4 ± 36.3; Americas: 55.3 ± 42.8; Asia: 26.6 ± 25.1; p < 0.001), with differences in sleep/fatigue, urinary, sexual, and miscellaneous domains (p ≤ 0.020). The best predictor of quality of life was the mood/apathy domain (β = 0.308, p < 0.001). This global study reveals that while non-motor symptoms are globally present with severe NMS burden impacting quality of life in PD, there appear to be differences depending on disease duration and geographical distribution.
Highlights
Growing evidence suggests that non-motor symptoms (NMS) in Parkinson’s disease (PD) have differential progression patterns that have a different natural history from motor progression and may be geographically influenced
The key findings were: (a) A universal presence of NMS irrespective of age, motor severity, disease duration and geographical site of assessment, with an overall severe non-motor burden; (b) Most frequently, the highest domain burden was observed for the sleep/fatigue, mood/apathy, urinary, and miscellaneous domains; (c) NMS impacted significantly on quality of life, which was best predicted by the mood/apathy and sleep/ fatigue domains of the Non-Motor Symptoms Scale (NMSS); (d) The burden of NMS increased with disease duration, starting after five years since diagnosis; (e) Geographical non-motor burden differences appear to exist, with the highest NMSS scores in the Americas and the lowest in Asia, with marked differences in the burden of specific non-motor domains, including sleep/fatigue, urinary, and miscellaneous domains
A large body of evidence has confirmed the marked importance of NMS for QoL in PD patients
Summary
Growing evidence suggests that non-motor symptoms (NMS) in Parkinson’s disease (PD) have differential progression patterns that have a different natural history from motor progression and may be geographically influenced. The best predictor of quality of life was the mood/apathy domain (β = 0.308, p < 0.001) This global study reveals that while non-motor symptoms are globally present with severe NMS burden impacting quality of life in PD, there appear to be differences depending on disease duration and geographical distribution
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have