Associations between non-motor symptoms and patient characteristics in Parkinson's disease: a multicenter cross-sectional study

Remi Morimoto; Mutsumi Iijima; Yasuyuki Okuma; Keisuke Suzuki; Fumihito Yoshii; Shigeru Nogawa; Takashi Osada; Kazuo Kitagawa

doi:10.3389/fnagi.2023.1252596

Associations between non-motor symptoms and patient characteristics in Parkinson's disease: a multicenter cross-sectional study

Front Aging Neurosci. 2023 Sep 6:15:1252596. doi: 10.3389/fnagi.2023.1252596. eCollection 2023.

Authors

Remi Morimoto¹, Mutsumi Iijima¹, Yasuyuki Okuma², Keisuke Suzuki³, Fumihito Yoshii⁴, Shigeru Nogawa⁵, Takashi Osada⁶, Kazuo Kitagawa¹

Affiliations

¹ Department of Neurology, School of Medicine, Tokyo Women's Medical University, Tokyo, Japan.
² Department of Neurology, Juntendo University Shizuoka Hospital, Shizuoka, Japan.
³ Department of Neurology, Dokkyo Medical University, Tochigi, Japan.
⁴ Department of Neurology, Saiseikai Shonan Hiratsuka Hospital, Kanagawa, Japan.
⁵ Department of Neurology, Tokai University Hachioji Hospital, Tokyo, Japan.
⁶ Department of Neurology, National Center of Neurology and Psychiatry, Tokyo, Japan.

Abstract

Objective: Parkinson's disease (PD) is characterized by various non-motor symptoms (NMS), such as constipation, olfactory disturbance, sleep disturbance, mental disorders, and motor symptoms. This study aimed to investigate factors associated with NMS in patients with PD.

Methods: Symptoms of PD were evaluated using the Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS), Parts I-IV. NMS was assessed using the MDS-UPDRS Part I (self-assessment of NMS) and rapid eye movement sleep behavior disorder (RBD) questionnaires. Patients were categorized by age into <70 years and ≥ 70 years (older adults) groups, according to disease duration into early-stage and advanced-stage groups with a cut-off value of 5 years for motor symptoms, and by sex into male and female groups.

Results: A total of 431 patients with PD (202 males and 229 females) with a mean age of 67.7 years, a mean disease duration of 6.4 years, and a mean Part I total score of 9.9 participated in this study. The Part I total score was significantly positively correlated (p < 0.01) with disease duration and Part II, III, and IV scores. For Part I sub-item scores, the older group had significantly higher scores for cognitive impairment, hallucinations, sleep problems, urinary problems, and constipation than the <70 years group, whereas the advanced-stage group had significantly higher scores for hallucinations, sleep problems, daytime sleepiness, pain, urinary problems, and constipation (p < 0.05) than the early-stage group. Anxiety was higher in female patients than in male patients, whereas daytime sleepiness, urinary problems, and RBD were higher in male patients than in female patients (p < 0.05). Factors affecting Part I included disease duration, Part II total scores, Part IV total scores, and RBD.

Conclusion: According to the self-questionnaire assessment, NMS was highly severe in older adult patients, those with longer illness duration, subjective and objective motor function impairments, and RBD. Sex-based differences were also observed.

Keywords: Japan; Parkinson’s disease; non-motor symptoms; older adults; self-questionnaire.