Abstract
Background: Parkinson’s disease (PD) remains a challenge for neurologists, particularly in its advanced stages when non-motor symptoms become a burden for the patient. While motor symptoms may be satisfactorily controlled with levodopa therapy or continuous levodopa/carbidopa intestinal gel (LCIG) administration, autonomic, sleep and mental disorders are hard to treat. During the last years, researchers have shifted their interest more to non-motor symptoms, PD being now considered a complex multiorgan impairment. Objective: The aim of this study was to describe non-motor symptoms in 40 Romanian patients diagnosed with PD, under conventional and LCIG administration treatment. Methods: A cross-sectional observational study was conducted, consisting of two groups of 20 patients each: the first group comprised PD patients who received conventional Levodopa treatment, while the second group was formed of patients receiving LCIG therapy. Various data concerning patient’s age, gender, duration of illness, comorbidities, motor and non-motor symptoms were recorded. The data were processed in SPSS v.20. Results: Subjects under continuous LCIG administration, although showing amelioration of motor symptoms, complained more frequently of constipation, mental, and sleeping disorders (statistically significant). Regarding anosmia, orthostatic hypotension, hypersalivation, urinary incontinence and restless legs syndrome, no statistical significant difference was observed between the two groups (p > 0.05). Conclusion: Nowadays, more research is conducted on non-motor symptoms in PD patients, as therapeutic measures try to limit these burdens, in order to improve patient’s quality of life.
Highlights
Parkinson’s disease (PD) is a complex neurodegenerative neurological disease resulting from the destruction of dopaminergic neurons from the substantia nigra pars compacta
Early PD is dominated by motor symptoms, including bradykinesia, rigidity, resting tremor, and postural instability, as the initial complaints that bring the patient to the neurologist, as well as the main diagnostic criteria (UKPDSBB Criteria) [4]
To conduct this cross-sectional observational study, we followed patients diagnosed with PD who were admitted between January 2017 and January 2019 to the hospital’s neurology department and divided them into two groups of 20 patients each according to treatment type: the first group of patients was orally treated with levodopa, while subjects from the second group received continuous infusion of levodopa 20 mg/ml + carbidopa monohydrate 5 mg/ml intestinal gel
Summary
Parkinson’s disease (PD) is a complex neurodegenerative neurological disease resulting from the destruction of dopaminergic neurons from the substantia nigra pars compacta. PD is defined by the progressive loss of dopaminergic neurons, other neurotransmission systems (noradrenergic, cholinergic, and serotoninergic) degenerate concomitantly [2] These non-dopaminergic lesions reflect the disease’s clinical heterogeneity, with symptoms and non-resistance to conventional therapy varying between patients [3] [4] [5]. Because motor characteristics in patients are heterogeneous, specialists have attempted to classify the condition into subtypes [6] [7] Consensus regarding these subtypes remains elusive, but empirical clinical observations suggest two major subtypes: PD with dominant tremor (with relative absence of other motor symptoms) and PD without dominant tremor (which includes phenotypes described as akinetic syndrome and stiffness and walking disorders with postural instability) [8] [9]. Conclusion: Nowadays, more research is conducted on non-motor symptoms in PD patients, as therapeutic measures try to limit these burdens, in order to improve patient’s quality of life
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