Impact of autonomic dysfunctions on the quality of life in Parkinson’s disease patients

Tomić, Svetlana; Rajkovaca, Ines; Pekić, Vlasta; Salha, Tamer; Mišević, Sanja

doi:10.1007/s13760-016-0739-6

Cited by 39 publications

(49 citation statements)

References 16 publications

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“…The most frequent NMSs were the urinary disturbances, which is in line with several previous studies ( 20 , 37 – 39 ). Urinary disturbances reported in PD patients are diverse and their prevalence through studies is different.…”

Section: Discussionsupporting

confidence: 92%

Non-Motor Symptoms of Parkinson’s Disease and Their Impact on Quality of Life in a Cohort of Moroccan Patients

Tibar

Bayad²,

Bouhouche

et al. 2018

Front. Neurol.

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BackgroundNon-motor symptoms (NMSs) are a real burden in Parkinson’s disease (PD). They may appear in early pre-symptomatic stage as well as throughout the disease course. However, their relationship with the deterioration of the patient’s quality of life (QoL) is still under debate. This study aimed to investigate the prevalence of NMSs and their impact on the QoL in a cohort of Moroccan patients.MethodsWe carried out a cross-transactional study, where a total of 117 patients were submitted to a structured clinical interview and examination investigating motor and NMSs based on common and conventional scales. Motor symptoms were assessed by the UPDRS I–VI during ON condition. The NMSs were evaluated with common scales and their relationship with the QoL was investigated.ResultsThe mean patient’s age was 60.77 ± 11.36 years old, and the median disease duration was 6 years [2.5–9.5]. Motor’s phenotype subtypes were the mixed form in 40.2% of patients, akinetic-rigid in 20.5% and a tremor-dominant form in 39.3%. The median Hoehn and Yahr staging was 2 [1–2.5]. Regarding NMSs, the most common were urinary dysfunctions (82.6%), sleep (80.6%), and gastrointestinal (80%) disorders. Other autonomic dysfunctions were also frequent: thermoregulatory dysfunctions 58.6%, cardiovascular troubles 50.9%, and sexual dysfunctions 47.9%. Depression was present in 47.9% and fatigue symptoms in 23.1%. The median score of SCOPA-AUT was 14 [7.75–21.80]. The median PD questionnaire 39-score index (PDQ39-SI) was 23.22% and the most affected dimension was “mobility.” Univariate and multivariate analyses showed that the SCOPA-AUT score impacted the QoL (p = 0.001), especially the gastrointestinal (p = 0.007), and cardiovascular (p = 0.049) dimensions.ConclusionOur data show that all patients have presented at least one NMS. Autonomic and sleep disorders were the most frequent, and in contrast to other studies, digestive and cardiovascular disorders were rather the factors influencing negatively the QoL of patients. Understanding the pathophysiology of these NMSs should be placed at the forefront in order to develop new therapeutic approaches by improving the QoL of PD patients.

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Section: Discussionsupporting

confidence: 92%

Non-Motor Symptoms of Parkinson’s Disease and Their Impact on Quality of Life in a Cohort of Moroccan Patients

Tibar

Bayad²,

Bouhouche

et al. 2018

Front. Neurol.

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“…In line with former studies, we observed a high frequency of sexual and urinary dysfunction [13][14][15]. In accordance with other studies, age and disease duration did not influence the severity of autonomic dysfunction [6,16]. As expected, we observed more autonomic symptoms in patients with higher disease stages and higher NMS-Quest.…”

Section: Discussionsupporting

confidence: 92%

“…As expected, we observed more autonomic symptoms in patients with higher disease stages and higher NMS-Quest. Corresponding to the literature, autonomic syndromes worsen health-related QoL, as assessed by the PDQ-39 SI [3,6,17,18]. Our study confirms and details this observation.…”

Section: Discussionsupporting

confidence: 90%

“…e severity of autonomic symptoms was associated with higher age, longer disease duration, greater disease severity, and higher doses of dopaminergic medication [4,5]. However, in another study of 40 patients with PD, autonomic dysfunction did not correlate with age or motor symptoms [6]. Dysautonomia was also found to be associated with impaired health-related quality of life (QoL) and disease progression [7,8].…”

Section: Introductionmentioning

confidence: 99%

“…Dysautonomia was also found to be associated with impaired health-related quality of life (QoL) and disease progression [7,8]. Many aspects of QoL (e.g., activity of daily living, emotion, cognitive functions, communication, and social support) can be affected by autonomic dysfunction [6].…”

Section: Introductionmentioning

confidence: 99%

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Sicca Symptoms in Parkinson’s Disease: Association with Other Nonmotor Symptoms and Health-Related Quality of Life

Prell

Schaller

Perner

et al. 2020

Parkinson's Disease

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Background. Frequently used nonmotor scales do not cover all aspects of dysautonomia in Parkinson’s disease (PD). This study explores the association between autonomic symptoms and sicca symptoms with other nonmotor symptoms and health-related quality of life (QoL) in PD. Methods. Autonomic symptoms (Survey of Autonomic Symptoms, SASs), motor function (Movement Disorder Society-sponsored revision of the Unified Parkinson’s Disease Rating Scale III, MDS-UPDRS III), nonmotor symptoms (nonmotor symptoms questionnaire, NMS-Quest), and QoL (PD Questionnaire-39, PDQ-39) were analysed in 93 PD patients without dementia. Multivariable and multivariate analyses were performed to study the association between clinical parameters and PDQ-39 domains. Results. Among the autonomic symptoms, sicca symptoms (xerostomia and dry eyes) were the most commonly reported (69%), followed by sexual dysfunction in men, leaking of urine, vasomotor dysfunction, constipation, sudomotor dysfunction, and orthostatic symptoms. The autonomic symptom burden (SAS total) correlated with the NMS-Quest and Hoehn and Yahr stage, but not with age, levodopa equivalent daily dose, disease duration, and the MDS-UPDRS III. The SAS total score was an independent predictor of the PDQ-39 summary index and mainly affected the PDQ-39 cognition and emotional well-being domains. Sicca symptoms were not associated with age, MDS-UPDRS III, disease duration, Hoehn and Yahr stage, and levodopa equivalent daily dose but aggravated the PDQ-39 domains: cognition, emotional well-being, bodily discomfort, and mobility. Sicca symptoms frequently occur together with other nonmotor symptoms, namely, urine urgency, orthostatic problems, and concentration problems. Overall, 75% of the subjects took at least one drug that can cause sicca symptoms (anti-PD medication, antidepressant drugs, antihypertensive drugs, antipsychotic drugs, antimuscarinic drugs, and analgesic drugs). Conclusion. Sicca symptoms are common in PD and negatively influence QoL. The observed association between sicca symptoms and other nonmotor symptoms provides further preliminary evidence for the growing recognition of different nonmotor clusters in PD.

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Activities of daily living as a longitudinal moderator of the effect of autonomic dysfunction on anxiety and depression of Parkinson's patients

et al. 2021

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Background: There is no clear time point for the onset of depression and anxiety in Parkinson's disease (PD), and their atypical physical symptoms often overlap with other nonmotor symptoms. Autonomic dysfunction usually appears earlier than motor symptoms, seriously impairing activities of daily living (ADL), even quality of life. Whether autonomic dysfunction can affect depression and anxiety in PD patients through ADL is still unclear. Methods:We conducted three progressive autoregressive mediation models to evaluate whether ADL may mediate the association between autonomic symptom burden, where the mediation chain with autonomic function as an independent variable, ADL as a mediating variable, and anxiety and depression as dependent variables. The ADL of PD patients were measured by the Scales for Outcomes in Parkinson's disease-Autonomic (SCOPA-AUT) and Modified Schwab and England ADL scale, respectively, and the status of depression and anxiety were measured by the Geriatric Depression Scale (GDS) and State-Trait Anxiety Inventory (STAI).Results: There were 338 PD patients, including 220 males and 118 females. Demographic information, including age, gender, and education level, were not correlated with the depression and anxiety. Model III had the smallest AIC (AIC = 12,669.89), and the cross-lagged relations were not statistically significant, so we selected Model II as the optimal model. In Model II, longitudinal autoregressive mediated effect and longitudinal mediated effect of autonomic dysfunction affecting anxiety and depression through ADL were not statistically significant, suggesting longitudinal changes of autonomic dysfunction were independent of anxiety and depression through ADL.Contemporaneous mediated effects of autonomic dysfunction affecting anxiety and depression through ADL were statistically significant, suggesting contemporaneous autonomic dysfunction may contribute to anxiety and depression through ADL.This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

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Impact of autonomic dysfunctions on the quality of life in Parkinson’s disease patients

Cited by 39 publications

References 16 publications

Non-Motor Symptoms of Parkinson’s Disease and Their Impact on Quality of Life in a Cohort of Moroccan Patients

Non-Motor Symptoms of Parkinson’s Disease and Their Impact on Quality of Life in a Cohort of Moroccan Patients

Sicca Symptoms in Parkinson’s Disease: Association with Other Nonmotor Symptoms and Health-Related Quality of Life

Activities of daily living as a longitudinal moderator of the effect of autonomic dysfunction on anxiety and depression of Parkinson's patients

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