Abstract
Despite the clinical impact of non-motor symptoms (NMS) in Parkinson’s disease (PD), the characteristic NMS in relation to the motor subtypes of PD is not well elucidated. In this study, we enrolled drug-naïve PD patients and compared NMS between PD subtypes. We enrolled 136 drug-naïve, early PD patients and 50 normal controls. All the enrolled PD patients were divided into tremor dominant (TD) and non-tremor dominant (NTD) subtypes. The Non-Motor Symptom Scale and scales for each NMS were completed. We compared NMS and the relationship of NMS with quality of life between normal controls and PD patients, and between the PD subtypes. Comparing with normal controls, PD patients complained of more NMS, especially mood/cognitive symptoms, gastrointestinal symptoms, unexplained pain, weight change, and change in taste or smell. Between the PD subtypes, the NTD subtype showed higher total NMS scale score and sub-score about weight change. Weight change was the characteristic NMS related to NTD subtype even after controlled other variables with logistic regression analysis. Even from the early stage, PD patients suffer from various NMS regardless of dopaminergic medication. Among the various NMS, weight change is the characteristic NMS associated with NTD subtype in PD patients.
Highlights
From early stage, Parkinson’s disease (PD) patients suffer from various non-motor symptoms (NMS) as well as classic motor symptoms, and NMS can impact the quality of life even more than motor symptoms as the disease progresses [1,2,3]
Subtypes of PD are determined by main motor symptoms [4], and it is well-known that PD patients with non-tremor dominant (NTD) subtype show more severe motor symptoms and aggressive disease progression than those with tremor-dominant (TD) subtype [5, 6]
There were no significant differences in PD sleep scale (PDSS), Parkinson Fatigue Scale (PFS), Beck Depression Inventory (BDI), Beck’s Anxiety Inventory (BAI), MoCA-K score
Summary
Parkinson’s disease (PD) patients suffer from various non-motor symptoms (NMS) as well as classic motor symptoms, and NMS can impact the quality of life even more than motor symptoms as the disease progresses [1,2,3]. NMS could be regarded to be more severe in PD patients with NTD subtype than those with TD subtype. Previous studies already reported the difference in some NMS among PD subtypes, but these previous studies focused only few specific NMS among PD subtypes, not the whole spectrum of nonmotor involvement [7,8,9,10]. There was only one study with systematic assessment of whole spectrum of NMS among PD subtypes, but this study investigated only the number of involved NMS among the PD subtypes, not the severity of NMS [11]. Few studies enrolled drug-naïve PD patients, but these studies mainly focused on premotor NMS, not the whole pattern of non-motor involvement in relation to the PD subtypes [13, 14]
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