Abstract
The 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.
Highlights
Non-motor symptoms (NMS) are frequently reported in patients with Parkinson’s disease (PD), which can occur either in the early stage or in the advanced stage of PD and may even precede the motor symptoms of the disease[1]
Baseline and follow-up data The demographic and clinical features of the patients with PD included in the study are listed in Supplementary Table 1
We included 224 PD patients at baseline (121 men and 103 women), and 195 patients completed the annual visits for 3 years
Summary
Non-motor symptoms (NMS) are frequently reported in patients with Parkinson’s disease (PD), which can occur either in the early stage or in the advanced stage of PD and may even precede the motor symptoms of the disease[1]. NMS are gaining increasing relevance in the management of PD, as they can greatly contribute to significant disability and reduced health-related quality of life[2,3]. A growing number of cross-sectional and case-control studies have explored the clinical characteristics of NMS in early PD, consistently demonstrating a high prevalence across the spectrum of NMS and a correlation with the degree of motor disability[5,6]. Our previous cross-sectional study[7] found that age, disease duration, and motor disability contribute to the severity of NMS. A previous case-control study[8] found that NMS are present throughout all stages of PD and their number increases with the severity of the disease and age. Further research involving the Asian population is warranted to gain a deeper understanding about the longitudinal evolution of NMS in patients with PD, as current evidence suggests that there are ethnic differences in the NMS burden
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