Background/Aims: Drooling or sialorrhea is a common non-motor symptom of Parkinson’s disease (PD), and is reported by 35–75% of patients. Drooling is primarily due to impaired swallowing rather than hypersecretion of saliva. In this study, we examined the prevalence of drooling in PD and its relation to various factors such as age, stage of disease, gender and ethnicity. Methods: A retrospective cohort chart analysis of 307 patients with idiopathic PD was conducted. These patients were seen in the Parkinson’s Disease and Movement Disorders Clinic between 2005 and 2010. Results: 123 (40%) patients exhibited drooling. No correlation between age and development of drooling was observed. However, gender was found to be a significant factor in developing sialorrhea. Males are twice as more likely to develop sialorrhea than females. In addition, drooling becomes more prevalent with disease progression; Hoehn and Yahr stage 4 patients being the most at risk. Ethnicity and immigration status have no relationship in developing drooling. Conclusions: Sialorrhea is seen in a significant number of PD patients. This study, to the best of our knowledge, is the most extensive clinical assessment of drooling in PD to date.
The results indicate that AT has extensive presence in PD. This and its seemingly close relationship to RT suggest that AT may be considered a variant of RT, particularly in PD patients. The degree of association between RT and AT needs to be further analyzed in PD, as well as in essential tremor (ET) and ET-PD.
Future research is indeed required to understand why certain ethnicities are especially at risk. Clinicians must also be aware of the epidemiology of nocturia in PD to prevent and treat this debilitating symptom.
Aim: While much research has been conducted towards understanding the basis of visual hallucinations in Parkinson's disease, little has focused on characterizing the content and patients' emotional experience. These factors are likely very influential on a patient's decision to seek treatment, a critical aspect of any symptom from the clinical perspective. Results: The study consisted of 334 patients with Parkinson's disease, among whom 10.5% had visual hallucinations. Hoehn and Yahr disease stage (P = 0.001), concurrent presence of dementia (P = 0.001), and sex (P = 0.031) were significant onset predictors. The most significant determinant of treatmentseeking was emotional reaction, namely whether hallucinations were bothersome (P = 0.008). However, the specific type of content during hallucinations was sometimes more influential and contradicted emotional response. Methods: Conclusion:Although treatment-seeking can be predicted by how individuals feel about hallucinations, a patient's decision may not be logically consistent. We suggest that clinicians offer treatment based on patients' recollections and opinions. Key words:Parkinson's disease, psychosis, treatment, visual hallucination. V ISUAL HALLUCINATIONS (VH) are reportedly observed in approximately one-third of Parkinson's disease (PD) patients, 1 although some variation has been suggested by different sources.2,3 The presence of this non-motor symptom is now well recognized and no longer considered a side-effect of anti-parkinsonian medication. 4 The basis of VH in PD is still not completely understood. It has been suggested that they may occur due to deficiencies within the lower levels of visual processing, such as with attention, This study observes various factors contributing to a patient's desire to treat VH in a clinical sample. It further focuses on hallucination content and personal emotional reflections on VH. To the best of our knowledge, these factors have not been analyzed concurrently.Since these factors lead to a horrid experience, they would be the greatest motivation for treatment. The data was also used to analyze correlations between the prevalence of visual hallucinations and patient sex, age, disease progression, and presence of dementia. METHODS Patient sourceAll 334 individuals in the study were patients diagnosed with idiopathic PD and regularly followed in a community-based PD and movement disorders center from 2005 to 2011. The PD diagnoses were based on the UK Parkinson's Disease Society Brain Bank clinical diagnostic criteria.14 Atypical parkinsonism was excluded for consistency. Altogether, 11 met the exclusion criteria and we removed them from analyses, except where stated otherwise.The method of this study conforms to the provisions of the Declaration of Helsinki in 1995 (as revised in Tokyo 2004) and has been approved by the ethics committee of the Centenary Hospital part of the Rouge Valley Health System. All participants gave informed consent and anonymity has been preserved. Evaluation of VHEach patient was questioned...
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