Kumar M Prakash1, Nivedita V Nadkarni2, Weng-Kit Lye2, Ming-Hui Yong3, Lai-Mun Chew4, Eng-King Tan5. 1. Department of Neurology, Singapore; Singapore General Hospital, Singapore; National Neuroscience Institute, Singapore; Duke-NUS Graduate Medical School, Singapore. Electronic address: gnrpk@sgh.com.sg. 2. Centre for Quantitative Medicine, Singapore; Duke-NUS Graduate Medical School, Singapore. 3. Department of Neurology, Singapore; Singapore General Hospital, Singapore. 4. Department of Neurology, Singapore; Singapore General Hospital, Singapore; National Neuroscience Institute, Singapore. 5. Department of Neurology, Singapore; Singapore General Hospital, Singapore; National Neuroscience Institute, Singapore; Duke-NUS Graduate Medical School, Singapore.
Abstract
BACKGROUND: Non-motor symptoms (NMS) are common among patients with Parkinson's disease (PD) however little is known about their progression in terms of severity or burden after referral to expert care. OBJECTIVE: This study was aimed to establish the progression of NMS burden in PD patients after referral to tertiary healthcare centre and factors affecting it. METHODS: Newly referred PD patients were prospectively enrolled and follow-up for up to 18 months. Non-motor symptoms scale (NMSS) was used to evaluate the burden of non-motor symptoms. RESULTS: There was a significant median reduction of total NMS burden over the follow-up period. Similarly all NMS domains except domains 2 (sleep/fatigue), 3 (mood/cognition), 6 (gastrointestinal) and 7 (urinary) showed significant median reduction of scores. In the univariate regression analysis, Hoehn & Yahr staging, disease duration, visit, Schwab & England Activities of Daily Living score and UPDRS motor scores were individually predictive of change in total NMS burden. However, in the multivariable regression analysis only the latter three were significantly predictive of change in the total NMS burden. CONCLUSION: There was a significant reduction of total NMS burden over the study period. The severity of motor and activity of daily living impairments as well as subsequent visit were the best predictors of NMS change.
BACKGROUND: Non-motor symptoms (NMS) are common among patients with Parkinson's disease (PD) however little is known about their progression in terms of severity or burden after referral to expert care. OBJECTIVE: This study was aimed to establish the progression of NMS burden in PDpatients after referral to tertiary healthcare centre and factors affecting it. METHODS: Newly referred PDpatients were prospectively enrolled and follow-up for up to 18 months. Non-motor symptoms scale (NMSS) was used to evaluate the burden of non-motor symptoms. RESULTS: There was a significant median reduction of total NMS burden over the follow-up period. Similarly all NMS domains except domains 2 (sleep/fatigue), 3 (mood/cognition), 6 (gastrointestinal) and 7 (urinary) showed significant median reduction of scores. In the univariate regression analysis, Hoehn & Yahr staging, disease duration, visit, Schwab & England Activities of Daily Living score and UPDRS motor scores were individually predictive of change in total NMS burden. However, in the multivariable regression analysis only the latter three were significantly predictive of change in the total NMS burden. CONCLUSION: There was a significant reduction of total NMS burden over the study period. The severity of motor and activity of daily living impairments as well as subsequent visit were the best predictors of NMS change.
Authors: Diego Santos-García; Teresa de Deus; Carlos Cores; Hector Canfield; Jose M Paz González; Cristina Martínez Miró; Lorena Valdés Aymerich; Ester Suárez; Silvia Jesús; Miquel Aguilar; Pau Pastor; Lluis Planellas; Marina Cosgaya; Juan García Caldentey; Nuria Caballol; Ines Legarda; Jorge Hernández-Vara; Iria Cabo; Lydia López Manzanares; Isabel González Aramburu; Maria A Ávila Rivera; Maria J Catalán; Victor Nogueira; Victor Puente; Julio Dotor; Carmen Borrué; Berta Solano; Maria Álvarez Sauco; Lydia Vela; Sonia Escalante; Esther Cubo; Francisco Carrillo; Juan C Martínez Castrillo; Pilar Sánchez Alonso; Gemma Alonso; Nuria López Ariztegui; Itziar Gastón; Jaime Kulisevsky; Marta Blázquez; Manuel Seijo; Javier Rúiz Martínez; Caridad Valero; Monica Kurtis; Oriol de Fábregues; Jessica Ardura; Ruben Alonso; Carlos Ordás; Luis M López Díaz; Darrian McAfee; Pablo Martinez-Martin; Pablo Mir Journal: J Pers Med Date: 2021-06-30