Non-motor symptoms in atypical and secondary parkinsonism: the PRIAMO study

Abstract

The PRIAMO study is a cross-sectional longitudinal observational study aimed at describing epidemiology and evolution of non-motor symptoms (NMS) in patients with different forms of parkinsonism recruited in 55 Italian centres and evaluated over 24 months. In this paper, we are reporting prevalence and clinical characteristics of NMS in patients with atypical and secondary parkinsonism. Out of 1307 consecutive patients with a diagnosis of parkinsonism, 83 patients had vascular parkinsonism (VP), 34 had multiple system atrophy (MSA), 30 had progressive supranuclear palsy (PSP), 14 had dementia with Lewy bodies (DLB) and 11 had corticobasal degeneration (CBD). MSA and DLB had the highest number of NMS domains and symptoms, respectively. Gastrointestinal symptoms, pain, urinary problems and postural instability due to orthostatic hypotension were most frequent in MSA. Sleep disturbances were also common with a prevalence of approximately 70% in all diagnostic groups but CBD (36%). Psychiatric symptoms and attention and memory impairment were frequently observed in all diagnoses but were most prevalent among DLB patients, whereas the prevalence of skin and respiratory disorders was rather low in all forms, ranging between 10 and 30%. Atypical parkinsonism patients also reported a low QoL, with no significant differences among the different forms, whereas PD and VP patients had a better QoL.

Sleep disorders in cerebellar ataxias

“…Another data comparing sleep disturbances in patients with PD, MSA and PSP demonstrated that patients with MSA showed higher risk of OSA and less frequent RLS 26 . The PRIAMO study, which analyzed non-motor symptoms in atypical and secondary parkinsonism, found that sleep disturbances were also common with a prevalence of approximately 70% in all diagnostic groups, including MSA patients 27 . RBD and nocturnal stridor are considered red flags and may be the first symptoms of the disease 22 .…”

Midlife migraine and late-life parkinsonism

“…1 Plausible mechanisms linking migraine with movement disorders include damage to relevant brain structures previously associated with migraine, 2 dopamine (DA) dysfunction (which has been hypothesized as a causal factor in migraine pathogenesis), 3 parkinsonism due to head injury or ischemic vascular disease (both of which are linked to migraine), [4][5][6] or damage related to iron deposition in the basal ganglia and related structures (also previously linked to migraine). [7][8][9][10] However, with the exception of restless legs syndrome (RLS), also known as Willis-Ekbom disease (WED), 11,12 the relationship between migraine and movement disorders has only been examined in samples specifically selected for presence of clinically diagnosed migraine or movement disorders, or in older cohorts when headache symptoms are retrospectively assessed.…”

A Review of Pain Prevalence in Alzheimer's, Vascular, Frontotemporal and Lewy Body Dementias

“…Eight studies were conducted in Europe [17,18,19,20,21,22,23,24,25] and two studies in the USA [26,27]. Five studies examined outcomes in nursing homes [23,24,25,26,27], whereas five studies examined outcomes in community-dwelling people or patients recruited from outpatient clinics [17,18,20,21,22].…”

“…Five studies examined outcomes in nursing homes [23,24,25,26,27], whereas five studies examined outcomes in community-dwelling people or patients recruited from outpatient clinics [17,18,20,21,22]. Five studies were cross-sectional [17,21,22,24,25,27], two longitudinal observational studies [19,23], one was a case-control study [18], one a retrospective cohort study [26] and one a randomized controlled trial [20]. The mean subject age ranged from 70 to 86 years.…”

“…Three studies focused solely on people with AD [17,21,22,27], five studies included people with AD, VaD, mixed pathologies and/or DLB [20,23,24,25,26], one study was a case-control study of AD and DLB [18] and one study included dementia subtypes based on motor neuron symptoms (i.e. parkinsonian syndromes) [19]. No study reported the prevalence of pain specific to people with FTD.…”