Shu-Jin He1, Zhen-Yang Liu1,2, Yu-Jie Yang1, Cong Shen1, Yu-Jie Du1, Xin-Yue Zhou1, Jue Zhao1, Yi-Min Sun1, Ke Yang1, Jian-Jun Wu1, Feng-Tao Liu3, Jian Wang4. 1. Department of Neurology and National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, 12 Wulumuqi Zhong Road, Jing'an District, Shanghai, 200040, China. 2. Intensive Care Unit, Huashan Hospital (West Campus), Fudan University, Shanghai, 201107, China. 3. Department of Neurology and National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, 12 Wulumuqi Zhong Road, Jing'an District, Shanghai, 200040, China. liufengtao@fudan.edu.cn. 4. Department of Neurology and National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, 12 Wulumuqi Zhong Road, Jing'an District, Shanghai, 200040, China. wangjian_hs@fudan.edu.cn.
Abstract
OBJECTIVE: Improvement of quality-of-life (QoL) has been termed as a primary objective in initiating therapy in both Parkinson's disease (PD) and multiple system atrophy Parkinsonian subtype (MSA-P). We aimed to compare the determinants of life quality in drug naïve PD and MSA-P patients. METHODS: Eighty-six drug-naïve PD patients and thirty-five drug-naïve MSA-P patients were included to explore the determinants of QoL. Demographic information, motor deficits, and non-motor symptoms were included in the clinical assessment. RESULTS: Both motor and non-motor functions were more severely impaired in the drug-naïve MSA-P patients, with higher PDQ-39 scores indicating poorer QoL. Physical discomfort and stigma were the main affected sub-domains in PD, while mobility and activity of daily life were the main affected ones in MSA-P. BECK depressive scores and UPDRS-III scores were independent variables of PDQ-39 in MSA-P patients. Age, depression, disease stages and non-motor scores were independent variables of PDQ-39 in PD patients. INTERPRETATION: Drug-naïve MSA-P patients suffered from more severe motor and non-motor disability, as well as poorer QoL. Depression and non-motor symptoms were proved to be the most critical determinants for QoL in PD, while motor function was supposed to be the major determinant for MSA-P. When initiating therapy, physicians need to focus more on motor functions in drug-naïve MSA-P patients, but on depression in PD patients.
OBJECTIVE: Improvement of quality-of-life (QoL) has been termed as a primary objective in initiating therapy in both Parkinson's disease (PD) and multiple system atrophy Parkinsonian subtype (MSA-P). We aimed to compare the determinants of life quality in drug naïve PD and MSA-Ppatients. METHODS: Eighty-six drug-naïve PDpatients and thirty-five drug-naïve MSA-Ppatients were included to explore the determinants of QoL. Demographic information, motor deficits, and non-motor symptoms were included in the clinical assessment. RESULTS: Both motor and non-motor functions were more severely impaired in the drug-naïve MSA-Ppatients, with higher PDQ-39 scores indicating poorer QoL. Physical discomfort and stigma were the main affected sub-domains in PD, while mobility and activity of daily life were the main affected ones in MSA-P. BECK depressive scores and UPDRS-III scores were independent variables of PDQ-39 in MSA-Ppatients. Age, depression, disease stages and non-motor scores were independent variables of PDQ-39 in PDpatients. INTERPRETATION: Drug-naïve MSA-Ppatients suffered from more severe motor and non-motor disability, as well as poorer QoL. Depression and non-motor symptoms were proved to be the most critical determinants for QoL in PD, while motor function was supposed to be the major determinant for MSA-P. When initiating therapy, physicians need to focus more on motor functions in drug-naïve MSA-Ppatients, but on depression in PDpatients.
Entities:
Keywords:
Drug-naïve; Multiple system atrophy; Parkinson’s disease; Quality of life
Authors: Iva Stankovic; Niall Quinn; Luca Vignatelli; Angelo Antonini; Daniela Berg; Elizabeth Coon; Pietro Cortelli; Alessandra Fanciulli; Joaquim J Ferreira; Roy Freeman; Glenda Halliday; Günter U Höglinger; Valeria Iodice; Horacio Kaufmann; Thomas Klockgether; Vladimir Kostic; Florian Krismer; Anthony Lang; Johannes Levin; Phillip Low; Christopher Mathias; Wassillios G Meissner; Lucy Norcliffe Kaufmann; Jose-Alberto Palma; Jalesh N Panicker; Maria Teresa Pellecchia; Ryuji Sakakibara; Jeremy Schmahmann; Sonja W Scholz; Wolfgang Singer; Maria Stamelou; Eduardo Tolosa; Shoji Tsuji; Klaus Seppi; Werner Poewe; Gregor K Wenning Journal: Mov Disord Date: 2019-04-29 Impact factor: 10.338
Authors: S Gilman; G K Wenning; P A Low; D J Brooks; C J Mathias; J Q Trojanowski; N W Wood; C Colosimo; A Dürr; C J Fowler; H Kaufmann; T Klockgether; A Lees; W Poewe; N Quinn; T Revesz; D Robertson; P Sandroni; K Seppi; M Vidailhet Journal: Neurology Date: 2008-08-26 Impact factor: 9.910