Parkinson's Disease Non-motor Symptoms Scale Research Articles

A study on the effects of the Qihuang Needle therapy on patients with Parkinson's disease.

This study aimed to evaluate the effectiveness of the Qihuang Needle (QHN) in treating Parkinson's disease (PD). The trial was an 8-week randomized clinical trial (4 weeks of treatment followed by 4 weeks of follow-up) conducted from January 2021 to July 2022 in outpatient settings at three clinical sites in Guangzhou, China. Thirty-four participants with PD were diagnosed based on the diagnostic criteria formulated by the brain bank of the British Parkinson's Disease Society in 1992. Patients in the treatment and control groups received six sessions within 4 weeks of the QHN therapy or the sham acupuncture therapy (two times per week for the first two consecutive weeks and one time per week for the following two consecutive weeks). The primary outcome measure was the change in the Parkinson's Disease Rating Scale-Part III Motor Examination (UPDRS III) between baseline and 8 weeks after treatments. Secondary outcome measures were the Non-Motor Symptoms Scale for Parkinson's Disease (NMSS) and Parkinson's Disease Daily Quality of Life-39 (PDQ-39). Real-time shear wave elastography (SWE) was assessed for each patient at baseline and during the 4-week period as the third outcome measure. A more significant reduction of UPDRS III score, PDQ-39, NMSS, and SWE was observed in the QHN group than in the sham acupuncture group. The QHN therapy consistently demonstrated superiority and produced clinically meaningful benefits in reducing motor and non-motor symptoms, as well as significantly improving muscle stiffness, in patients with PD.

Effects of Qihuang Needling on Motor Function for Patients With Parkinson's Disease: Study Protocol for a Multicenter, Randomized Controlled Trial.

BackgroundAlthough significant progress has been made in the pharmacologic management of Parkinson's Disease (PD), effective management of movement disorders is still a hurdle for therapeutics targeting PD. Acupuncture is one therapeutic option that could potentially improve the motor function of PD and is widely used as adjuvant therapy. Among the various acupuncture approaches, Qihuang Needling (QHN) therapy has been found to improve motor-function control for patients with PD. However, evidence regarding its efficacy remains scarce. Therefore, to address this need, this study will determine the effects of QHN therapy on motor function in patients with PD and compare it to placebo effects.MethodsThis trial is a multicenter, prospective randomized controlled clinical trial. We randomly allocated 144 participants to two groups of 72 patients. Patients in the treatment group were treated with QHN therapy. The control group had undergone insertion of acupuncture needles at sham acupoints not corresponded to acupuncture points. Participants in the verum treatment group and sham-acupuncture control group received 9 sessions over 6 weeks followed by 8 weeks of follow-up. The primary outcome was the change of motor function from baseline to weeks 6 and 14 measured by the PD Rating Scale-Part III Motor Examination (UPDRS-III). Secondary outcome measures included the change of PD daily quality of life-39 (PDQ-39) and Non-Motor Symptoms Scale for PD (NMSS) from baseline to weeks 6 and 14.DiscussionThe results of this trial will generate data to improve our general understanding of the efficacy of QHN therapy on motor function in patients with PD and thoroughly compare these responses to the placebo effect.Trial RegistrationThe trial was registered at the Chinese Clinical Trials Registry (ChiCTR- 2000030871) on 16 March 2020.

Effects of subthalamic deep brain stimulation on non‐motor symptoms of Parkinson's disease: A meta‐analysis

Deep brain stimulation (DBS) is a well-defined treatment for motor symptoms in advanced PD. Although several studies have investigated the DBS effect on non-motor symptoms (NMS), controversial results exist regarding this matter. The aim of this meta-analysis and systematic review was to assess the bilateral subthalamic nucleus (STN) DBS effect on NMS of PD. We conducted a systematic search on the literature of Web of Science (WOS), PubMed/MEDLINE, Scopus, Cochrane, and Embase. An additional hand search was also done. Finally, a meta-analysis was conducted on 10 studies containing pre- and post-bilateral STN-DBS data regarding NMS acquired using Non-Motor Symptoms Scale for Parkinson's Disease (NMSS) or Non-Motor Symptoms Questionnaire (NMSQ). A random-effects model was used to determine weighted mean differences, and the heterogeneity index was evaluated using Cochrane's Q test. Our study results indicated that bilateral STN-DBS significantly reduced total NMSS and NMSQ score (WMD -17.73; 95% confidence interval [CI] -20.28 to -15.18, WMD -2.19; 95% CI -2.98 to -1.40), respectively, and no publication bias was found. Regarding each of the NMSS domains, DBS significantly reduced the scores of following domains: sleep (WMD -5.98; 95% CI -6.82 to -5.15), miscellaneous (WMD -4.19; 95% CI -4.96 to -3.43), urinary (WMD -2.99; 95% CI -3.78 to -2.19), sexual (WMD -0.65; 95% CI -1.16 to -0.14), and attention/memory (WMD -0.59; 95% CI -1.15 to -0.03). This meta-analysis demonstrated that bilateral STN-DBS has beneficial effects on NMS of PD.

Improvement of Non-motor Symptoms and Quality of Life After Deep Brain Stimulation for Refractory Dystonia: A 1-Year Follow-Up.

Introduction: Deep brain stimulation (DBS) is a treatment option for refractory dystonia's motor symptoms, while its non-motor symptoms (NMS) have been less systematically assessed. We aimed to describe the effects of DBS on NMS in refractory generalized inherited/idiopathic dystonia prospectively.Methods: We evaluated patients before and 1 year after DBS surgery and applied the following scales: Burke–Fahn–Marsden Rating Scale (BFMRS), NMS Scale for Parkinson's Disease (NMSS-PD), Parkinson's Disease Questionnaire-8, short-form Brief Pain Inventory (BPI), Neuropathic Pain Symptom Inventory (NPSI), and short-form McGill Pain Questionnaire (MPQ).Results: Eleven patients (38.35 ± 11.30 years) underwent surgery, all with generalized dystonia. Motor BFMRS subscore was 64.36 ± 22.94 at baseline and 33.55 ± 17.44 1 year after DBS surgery (47.9% improvement, p = 0.003). NMSS-PD had a significant change 12 months after DBS, from 70.91 ± 59.07 to 37.18 ± 55.05 (47.5% improvement, p = 0.013). NMS changes were mainly driven by changes in the gastrointestinal (p = 0.041) and miscellaneous domains (p = 0.012). Seven patients reported chronic pain before DBS and four after it. BPI's severity and interference scores were 4.61 ± 2.84 and 4.12 ± 2.67, respectively, before surgery, and 2.79 ± 2.31 (0.00–6.25) and 1.12 ± 1.32 (0.00–3.00) after, reflecting a significant improvement (p = 0.043 and p = 0.028, respectively). NPSI score was 15.29 ± 13.94 before, while it was reduced to 2.29 ± 2.98 afterward (p = 0.028). MPQ's total score was 9.00 ± 3.32 before DBS, achieving 2.71 ± 2.93 after (p = 0.028).Conclusions: DBS improves NMS in generalized inherited/idiopathic dystonia, including chronic pain.

Nomogram for Predicting Postoperative Delirium After Deep Brain Stimulation Surgery for Parkinson's Disease

The purpose of the present study was to construct a nomogram for postoperative delirium (POD) after deep brain stimulation (DBS) surgery in patients with Parkinson's disease (PD). The present study retrospectively enrolled 165 patients with PD who had undergone DBS surgery. The patients were assessed using the Confusion Assessment Method for the Intensive Care Unit and were divided into 2 groups: the delirium group and nondelirium group. The nomogram for POD after DBS surgery was constructed from the results of univariate analysis and multivariate logistic analysis of the influencing factors for POD after DBS surgery. Univariate analysis revealed that the preoperative length of stay and the presence of preoperative brain atrophy, preoperative pulmonary inflammation, and postoperative cerebral edema were statistically significant. The results from the nonmotor symptoms scale for PD, mini-mental state examination, PD sleep scale, and unified PD rating scale III were also statistically significant (P < 0.05). Multivariate logistic regression analysis showed that the unified PD rating scale III (odds ratio [OR], 2.284; 95% confidence interval [CI], 1.614-3.232), nonmotor symptoms scale for PD (OR, 8.191; 95% CI, 5.629-11.917), PD sleep scale (OR, 0.058; 95% CI, 0.05-0.067), preoperative length of stay (OR, 1.230; 95% CI, 1.053-1.437), and preoperative brain atrophy (OR, 3.912; 95% CI, 3.5-4.255) were independent factors that influenced the occurrence of POD after DBS surgery. A nomogram model was constructed using these indicators. The model predicted an area under the receiver operating characteristic curve after DBS surgery of 0.870 (95% CI, 0.808-0.918), sensitivity of 74.19%, and specificity of 91.54%. The present study has presented a reliable and useful nomogram that can accurately predict the occurrence of POD after DBS surgery in patients with PD. This tool is easy to use and could assist physicians during the therapeutic decision-making process.

Serum 25-hydroxyvitamin D3 level may be associated with olfactory dysfunction in de novo Parkinson's disease

The purpose of our study was to investigate the association between olfactory function in Parkinson's disease (PD) and serum vitamin D status. Thirty-nine patients with de novo PD were enrolled in this study. Olfactory function was assessed by an odor identification test, as a part of the KVSS (Korean version of sniffin’ sticks) II test. All patients were also assessed with the NMSS (Non-Motor Symptoms Scale for PD) to check the subjective change in ability to smell. Vitamin D status was determined by measuring the level of serum 25-hydroxyvitamin D3 (25-OHD3). Multiple linear regression tests and correlation analysis were applied to verify the association between serum 25-OHD3 level and patients’ subjective and objective olfactory dysfunction. The serum 25-OHD3 level was independently associated with odor identification score in patients with PD (β = 0.38, p < 0.01). Another statistically significant variable was clinical subtype of PD (Intermediate subtype: β = −0.33, p < 0.05; Akinetic rigid type: β = −0.55, p < 0.01). The serum 25-OHD3 level was also negatively correlated with the score for item number 28 in NMSS (Spearman’s rho = −0.32, p < 0.05). Our results showed that vitamin D status might be an independent factor for olfactory dysfunction in PD. Although the underlying mechanism has not been clearly identified, we postulate that vitamin D plays a role in the pathogenesis of olfactory dysfunction in PD. Further investigation to elucidate the precise relationship of vitamin D to PD is essential.

Classification of Scans Without Evidence ofDopamine Deficit (SWEDD) According to the Olfactory Function.

Scans without evidence of dopaminergic deficit (SWEDD), a heterogeneous disorder, refers to patients with normal dopamine transporter scan presumed to have Parkinson's disease (PD). Although clinically hard to discriminate, it is important to differentiate SWEDD from PD in the early stage of disease in practice. Olfactory dysfunction is a sensitive biomarker of neurodegeneration. A considerable number of SWEDD patients show abnormal olfaction. We investigated the olfaction and non-motor symptoms in SWEDD, PD, and healthy controls. A subgroup analysis of SWEDD by olfactory function was also conducted. This study enrolled 40 SWEDD, 28 PD, and 26 healthy controls. The Korean version of Sniffin's stick test II (KVSS II) and the Korean version of non-motor symptoms scale for PD (K-NMSS) were used to evaluate olfaction and non-motor symptoms. Patients with SWEDD were categorized into normal olfaction (SWEDD-N) and olfactory dysfunction (SWEDD-D) subgroups. Overall KVSS II scores of SWEDD group was distinctive when compared to those of PD or controls. K-NMSS scores were increased in PD compared to those in SWEDD or controls. In subgroup analysis, KVSS II scores in SWEDD-D were similar to those in PD. K-NMSS scores in SWEDD-D were also significantly higher than those in SWEDD-N but lower than those in PD. Olfactory dysfunction could be a biomarker to differentiate SWEDD from PD. Non-motor symptoms differed between the two SWEDD subgroups classified by olfaction. These findings suggest that the underlying pathophysiology of SWEDD with normal olfaction and olfactory dysfunction might be different.

Effects of non-motor symptoms on health-related quality of life in Parkinson's disease

To explore the effects of non-motor symptoms (NMS) on health-related quality of life (HRQOL) in Parkinson's disease (PD) patients. By convenient sampling, 128 PD patients were recruited. NMS was assessed by the non-motor symptoms scale for PD (NMSS) and HRQOL by the 39-item PD Questionnaire (PDQ39). All PD patients (100%) had NMS with a general score of (124 ± 48) . Among these NMS, constipation was ranked the highest and the general level of NMS was significantly positively associated with age (r = 0.226, P < 0.05), Hoehn-Yahr staging (r = 0.442, P < 0.05) and disease course (r = 0.223, P < 0.05). However there was no correlation with gender (r = 0.085, P < 0.05). For PD patients, HRQOL became impaired with a general score of (44 ± 16) . Activities of daily living (60 ± 15), mobility (49 ± 21), emotional well-being (49 ± 28) and stigma (48 ± 46) were the most seriously affected. Females (χ² = -1.821 P < 0.05) and senile bereaved patients (χ² = -1.512, P < 0.05) had significantly lower HRQOL than that of others. For PD patients, the general level of HRQOL was significantly positively associated with disease course (r = 0.260, P < 0.05) and severity (r = 0.259, P < 0.05). The general level of HRQOL was significantly positively associated with the general level of NMS (r = 0.686, P < 0.01). Non-motor symptoms (NMS) are quite common in PD patients. For PD patients, NMS has a more negative impact on HRQOL than other symptoms.

Subjective poor sleep quality in Chinese patients with Parkinson's disease without dementia

Parkinson's disease (PD) is a common progressive neurological disorder and is composed of motor and non-motor symptoms. Sleep disturbances are frequent problems for patients with PD. The relationship between sleep disturbances with Hoehn and Yahr (H&Y) staging have been demonstrated. However, the relationship between sleep disorders and H&Y is still unclear in patients with PD without dementia in Chinese PD patients. In this study, we interviewed 487 non-demented PD patients of Chinese Han descents by H&Y classification. We found that night sleep quality was significantly associated with the severity of PD (P = 0.008). Panic disorder severity scale (PDSS) total scores were correlated with PD non-motor symptoms scale (PDNMS) scores (r = -0.528, P < 0.001), the Hamilton depression scale (HAMD) scores (r = -0.545, P < 0.001) and the Hamilton anxiety scale (HAMA) scores (r = -0.498, P < 0.001). Our results indicated that sleep quality deteriorated with the advancing of PD in Chinese non-demented patients with PD. Depression and anxiety may partly explain sleep disturbances in non-demented patients with PD.

Validation of the Korean-Version of the Nonmotor Symptoms Scale for Parkinson's Disease

Background and PurposeNon-motor symptoms are common in Parkinson's disease (PD), and are the primary cause of disability in many PD patients. Our aim in this study was to translate the origin non-motor symptoms scale for PD (NMSS), which was written in English, into Korean (K-NMSS), and to evaluate its reliability and validity for use with Korean-speaking patients with PD.MethodsIn total, 102 patients with PD from 9 movement disorders sections of university teaching hospitals in Korea were enrolled in this study. They were assessed using the K-NMSS, the Unified Parkinson's Disease Rating Scale (UPDRS), the Korean version of the Mini-Mental Status Examination (K-MMSE), the Korean version of the Montgomery-Asberg Depression Rating Scale (K-MADS), the Epworth Sleepiness Scale (ESS), and Parkinson's Disease Questionnaire 39 (PDQ39). Test-retest reliability was assessed over a time interval of 10-14 days in all but one patient.ResultsThe K-NMSS was administered to 102 patients with PD. The internal consistency and reliability of this tool was 0.742 (mean Cronbach's α-coefficient). The test-retest correlation reliability was 0.941 (Guttman split-half coefficient). There was a moderate correlation between the total K-NMSS score and the scores for UPDRS part I [Spearman's rank correlation coefficient, (rS)=0.521, p<0.001] and UPDRS part II (rS=0.464, p=0.001), but there was only a weak correlation between the total K-NMSS score and the UPDRS part III score (rS=0.288, p=0.003). The total K-NMSS score was significantly correlated with the K-MADS (rS=0.594, p<0.001), K-MMSE (rS=-0.291, p=0.003), and ESS (rS=0.348, p<0.001). The total K-NMSS score was also significantly and positively correlated with the PDQ39 score (rS=0.814, p<0.001).ConclusionsThe K-NMSS exhibited good reliability and validity for the assessment of non-motor symptoms in Korean PD patients.

1.126 Non-motor symptoms in akinesia dominant versus other phenotypes in Parkinson's disease (PD): Results form the international PD non-motor symptoms scale study

1.126 Non-motor symptoms in akinesia dominant versus other phenotypes in Parkinson's disease (PD): Results form the international PD non-motor symptoms scale study

1.014 Non-motor symptoms in akinesia dominant versus other phenotypes in Parkinson's disease (PD): Results from the international PD non-motor symptoms scale study

1.014 Non-motor symptoms in akinesia dominant versus other phenotypes in Parkinson's disease (PD): Results from the international PD non-motor symptoms scale study