Abstract
ObjectiveThe Bologna motor and non-motor prospective study on parkinsonism at onset (BoProPark) was designed to prospectively characterize motor and non-motor features in patients with a progressive neurodegenerative disease starting with parkinsonism since early disease stage and to investigate their diagnostic and prognostic role in the differential diagnosis of Parkinson’s disease from atypical parkinsonisms. The aim of this paper is to describe the method and population of the BoProPark study.MethodsPatients referred to our Department with parkinsonism within 3 years from motor onset were recruited. Secondary causes of parkinsonism were excluded. Each patient underwent a comprehensive evaluation of motor and non-motor symptoms, assessed by means of quantitative, objective instrumental tests in addition to scales and questionnaires. The evaluations were performed at enrolment (T0), after 16 months (T1) and after 5 years (T2). Diagnoses were made according to consensus criteria.ResultsWe recruited 150 patients, with mean age 61.5 ± 9.8 years and mean disease duration 20 ± 9 months. H&Y stage was 1 in 47.3% and 2 in 46.7% of cases. Mean UPDRS-III was 17.7 ± 9.2. Fifty-four patients were on dopaminergic treatment with median levodopa equivalent daily dose (LEDD) of 200 mg.ConclusionsWe expect that the prospective nature of the BoProPark study as well as the comprehensive, instrumental evaluation of motor and non-motor symptoms in patients with parkinsonism will provide important new insights for both clinical practice and research. Our data could be used for comparison with other cohorts and shared with national and international collaborators to develop new innovative projects.
Highlights
Parkinsonism is defined by the presence of a combination of bradykinesia, rigidity, tremor, and postural instability
It may be due to secondary causes or may occur in the context of neurodegenerative disorders, such as Parkinson’s disease (PD) or atypical parkinsonisms (APs)
APs are characterized by a worse prognosis and different therapeutic needs compared to PD
Summary
Parkinsonism is defined by the presence of a combination of bradykinesia, rigidity, tremor, and postural instability. It may be due to secondary causes (e.g., vascular encephalopathy, drugs’ side effects) or may occur in the context of neurodegenerative disorders, such as Parkinson’s disease (PD) or atypical parkinsonisms (APs). Several prospective studies have been promoted for this purpose, focusing on frequency, severity, impact on diagnosis, and prognosis of motor as well as non-motor symptoms (e.g., autonomic failure, sleep disorders, cognitive impairment). Most of these studies mainly assessed nonmotor symptoms by means of questionnaires and scales that, while being comprehensive and standardized screening tools, do not allow objective quantification and only capture patient self-reported symptoms [6]. The majority of these studies targeted patients with a single diagnosis, even though differentiating PD from APs at onset is still challenging [7]
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