Abstract
Purpose Autonomic dysfunction is a common nonmotor feature and early manifestation of Parkinsons disease (PD). Autonomic dysfunction in PD is associated with a worse prognosis. We sought to characterize autonomic dysfunction and identify associated factors in patients with early PD. Methods An observational, cross-sectional, descriptive, and analytical study was conducted to evaluate patients with early PD from the Parkinsons Progression Markers Initiative. We utilized the Scales for Outcomes in Parkinsons Disease-Autonomic dysfunction questionnaire to determine the prevalence and frequencies of autonomic symptomatology. The cohort was grouped into high and low dysautonomic scores. A regression model identified variables that independently explained dysautonomic scores in our early PD cohort. Results 414 PD patients had a mean age of 61.1 (SD 9.7) years at diagnosis and mean disease duration of 6.7 (SD 6.6) months. Among all patients, 43.7% (181/414) had high dysautonomic scores. Urinary and gastrointestinal symptoms were the most prevalent and frequently reported dysautonomic symptoms. Patients with fatigue (beta = 4.28, p < 0.001), probable rapid eye movement sleep behavior disorder (beta = 2.71, p < 0.001), excessive daytime sleepiness (beta = 1.88,p=0.039), impulsivity and compulsivity (beta = 2.42, p < 0.001), and increasing age (beta = 1.05, p < 0.001) were more likely to have high dysautonomic scores. Conclusion Lower urinary tract and gastrointestinal symptoms are prevalent and frequent in early PD patients. Fatigue, sleep disorders, impulsivity and compulsivity, and age are predictors of autonomic dysfunction. Autonomic symptoms predominated in this group of early PD patients in the disease course and were associated with more severe disease.
Highlights
Autonomic dysfunction in patients with Parkinson’s disease (PD) was initially reported in the clinical description of PD by James Parkinson in his essay on shaking palsy in 1817 [1]
Since people without PD can present with autonomic symptoms and higher SCOPA-AUT scores are more frequently associated with neurodegenerative synucleinopathies [10], dichotomizing outcome scores into high and low scores is necessary to help discriminate between symptoms related to PD and symptoms that are not related to PD. us, we sought to characterize autonomic dysfunction and identify associated factors in patients with early PD
A SCOPA-AUT score of ≥10 was observed in 43.7% (181/414) of the PD cohort
Summary
Autonomic dysfunction in patients with Parkinson’s disease (PD) was initially reported in the clinical description of PD by James Parkinson in his essay on shaking palsy in 1817 [1]. Autonomic dysfunction in PD is typically associated with negative outcomes and has been reported to be correlated with more severe disease [6]. Studies assessing autonomic dysfunction in PD have focused mainly on cardiovascular symptoms, and literature on patients with early PD is scarce. Identification of these patients with early PD is crucial for developing therapeutic strategies to prevent complications. E Scales for Outcomes in Parkinson’s Disease-Autonomic dysfunction (SCOPA-AUT) is a clinical questionnaire that assesses the presence and frequency of autonomic symptoms in patients with PD [9]. Since people without PD can present with autonomic symptoms and higher SCOPA-AUT scores are more frequently associated with neurodegenerative synucleinopathies [10], dichotomizing outcome scores into high and low scores is necessary to help discriminate between symptoms related to PD and symptoms that are not related to PD. us, we sought to characterize autonomic dysfunction and identify associated factors in patients with early PD
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call