The spectrum of nonmotor symptoms in early Parkinson disease

TLDR

Nonmotor symptoms are common in established Parkinson disease, yet their prevalence in early Parkinson disease remains poorly characterized. The study aimed to determine the frequency of nonmotor symptoms in patients with newly diagnosed Parkinson disease. The authors assessed 159 early Parkinson disease patients and 99 healthy controls using a nonmotor symptom questionnaire, along with motor, disease severity, depression, and cognitive evaluations. Patients with early Parkinson disease reported a higher mean number of nonmotor symptoms (8.4 vs 2.8 in controls), with excess saliva, forgetfulness, urinary urgency, hyposmia, and constipation most common, and greater motor impairment and postural instability gait subtype associated with more symptoms, indicating that nonmotor symptoms are frequent and impact functional status even at disease onset.

Abstract

OBJECTIVE: Nonmotor symptoms (NMS) are common in patients with established Parkinson disease (PD) but their frequency in early PD has not been extensively studied. Our aim was to determine the frequency of NMS in a cohort of patients with newly diagnosed PD. METHODS: A total of 159 patients with early PD and 99 healthy controls participated in this study. NMS were screened for using the nonmotor symptom questionnaire. Other assessments included measures of motor disability (Movement Disorders Society-revised unified Parkinson's disease rating scale [MDS-UPDRS]), disease severity (Hoehn & Yahr staging), depression (geriatric depression scale), and global cognitive function (Mini-mental state examination and Montreal cognitive assessment). RESULTS: The PD group reported a significantly greater number of NMS compared with controls (8.4 [4.3] vs. 2.8 [2.6]). In the PD group, the most commonly experienced NMS were excessive saliva, forgetfulness, urinary urgency, hyposmia, and constipation. Patients with higher MDS-UPDRS III scores and those with the postural instability gait subtype experienced a greater number of NMS. CONCLUSION: NMS are common in early PD and reflect the multisystem nature of the disorder. Even in the earliest stages of PD, NMS may be detrimental to patients' functional status and sense of well-being.