Clinical profile of Parkinson's disease in the Gumei community of Minhang district, Shanghai

Abstract

OBJECTIVE:We examined the demographic and clinical profiles of Parkinson's disease in Shanghai, China, to assist in disease management and provide comparative data on Parkinson's disease prevalence, phenotype, and progression among different regions and ethnic groups.METHODS:A door-to-door survey and follow-up clinical examinations identified 180 community-dwelling Han-Chinese Parkinson's disease patients (104 males, 76 females).RESULTS:The average age at onset was 65.16±9.60 years. The most common initial symptom was tremor (112 patients, 62.22%), followed by rigidity (38, 21.11%), bradykinesia (28, 15.56%) and tremor plus rigidity (2, 1.11%). Tremor as the initial symptom usually began in a single limb (83.04% of patients). The average duration from onset to mild Parkinson's disease (Hoehn-Yahr phase 1–2) was 52.74±45.64 months. Progression from mild to moderate/severe Parkinson's disease (phase≥3) was significantly slower (87.07±58.72 months; p<0.001), except for patients presenting initially with bradykinesia (53.83±24.49 months). Most patients (149/180, 82.78%) took levodopa with or without other drugs. The Hamilton Anxiety Scale revealed symptoms of clinical anxiety in 35 patients, and the Hamilton Depression Scale revealed depressive symptoms in 88 patients. The depressed or anxious subgroup (123 patients) demonstrated a significantly younger age at onset (55.54±7.68 years) compared with the overall mean (p<0.05).CONCLUSION:Unilateral limb tremor was the most common initial symptom, and motor function deteriorated slowly over ≈4−9 years. Earlier-onset patients experience greater psychiatric dysfunction.

A clinico-epidemiological profile of Parkinson’s disease patients attending the tertiary care hospital of hilly state of North India: a hospital based cross-sectional study

“…Liu et al also reported unilateral limb involvement in 73.63% patients and among these patients tremor was most frequently reported (70.99%). 8 In this study, 22 patients gave a history of postural instability (48.89%), out of which 13 patients (28.89%) gave a history of fall. The frequency of falls has also been reported to have a direct correlation with age, disease severity, medication, cognitive dysfunction, orthostatic hypotension, and visual impairment.…”

Rest tremor in Parkinson's disease: Body distribution and time of appearance

“…Three of such studies detected RT in the UL in 42% to 65% of cases and in the lower limb (LL) in 3.7% to 24% of cases. [5][6][7]; one additional study detected RT in the jaw/lips (JL) in < 2% of cases. [8] A further study assessing the distribution of RT in 50 PD patients after several years of follow-up confirmed the greater frequency of RT in the UL.…”

“…Methodological differences probably explain discrepancies across studies. For instance, the longer disease duration characterizing the studies by Liu [7] and Uitti [8], might have affected the accuracy of tremor selfreport. The greater LL-RT estimates provided by the studies by Gowers [5] and Patrick and Levy [6] could be related to the observation that these studies were performed before the advent of neuroimaging.…”

The effect of 8 weeks of treatment with transcranial pulsed electromagnetic fields on hand tremor and inter-hand coherence in persons with Parkinson’s disease

“…The classical PD tremor has a main frequency of 4–7 Hz and is most often present at rest in the hands or arms of the affected subjects. Postural and kinetic tremors are also common in the upper extremities whereas tremors in the lower extremities are rarer [2, 3]. Furthermore, re-emergent tremor in terms of tremor re-occurring after repositioning of the limb is frequent [4].…”