Affiliations: National Parkinson Foundation International Centre of Excellence, King's College Hospital NHS Foundation Trust, London, UK | National Center of Epidemiology and CIBERNED, Carlos III Institute of Health, Madrid, Spain | Department of Neurology, Forth Valley Royal Hospital, NHS Forth Valley | Salford Royal NHS Foundation Trust, Manchester, UK | United Lincolnshire Hospitals NHS Trust, Lincoln, UK | King's College London, UK | Anne Rowling Regenerative Neurology Clinic, University of Edinburgh, UK | Division of Clinical Neurosciences, Western General Hospital, Edinburgh
Note: [] Correspondence to: K. Ray Chaudhuri, NPF International Parkinson's Centre of Excellence, Neurology, 9th Floor Ruskin Wing, Kings College Hospital, Denmark Hill, London, SE5 9RS, UK. Tel.: +44 020 3299 8336; Fax: +44 020 3299 8358; E-mail: ray.chaudhuri@nhs.net
Abstract: Background: Recent studies have demonstrated that, contrary to common perception non-motor symptoms (NMS) occur and may dominate early and untreated stage of Parkinson's disease (PD). Objective: The aim of this ongoing study was to describe the overall NMS profile and burden in drug naïve PD patients (DNPD) compared to a group of long-term PD patients (LTPD, disease duration ≥15 years). Methods: Cross sectional UK data from a multicenter (16 sites) collaboration were obtained and specifically NMS dataset from validated scales were analysed in DNPD and LTPD patients. The NMS scale (NMSS) was used as the primary outcome variable. Results: Out of a current database of 468 PD patients, 57 were DNPD (58% males, mean age 64.8 years, median Hoehn and Yahr stage 1) and 25 were LTPD (44%, mean age 67.6 years, median Hoehn and Yahr stage 3). DNPD patients had a significantly lower (p = 0.001) NMSS score (mean 45.5, range 1–150) compared to the LTPD patients (mean 74.0, range 6–155), but 26.3% had severe and 19.3% had very severe burden of NMSS using NMSS cutoff scores. In comparison, 20.0% of the LTPD patients had severe and 60.0% very severe burden of NMS (p = 0.003). Conclusions: NMS are common in DNPD patients and over 45% may have severe to very severe burden of NMS, which is a key determinant of quality of life. In LTPD patients not only the burden of “very severe” NMS is significantly higher, but there are also differences in the profile of expression of NMS.
Keywords: Parkinson's disease, non-motor symptoms, NMS scale, drug naïve
