Non-motor symptoms of Parkinson's disease: diagnosis and management

Chaudhuri, K. Ray; Healy, Daniel G.; Schapira, Anthony H.V.

doi:10.1016/s1474-4422(06)70373-8

Cited by 2,277 publications

(1,801 citation statements)

References 121 publications

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“…Finally, PLM occurred in 32.5% patients which is also similar to other reports 16 . Risk factors reported in other studies include older age and severity of the disease 27,28 ; nevertheless none of these factors were associated with the frequency of PLM in our sample.…”

Section: Discussioncontrasting

confidence: 71%

Prevalence and correlates of sleep disorders in Parkinson’s disease: a polysomnographic study

Alatriste-Booth

Rodríguez-Violante

Camacho-Ordóñez

et al. 2015

Arq. Neuro-Psiquiatr.

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Objective: Sleep disorders in Parkinson's disease are very common. Polysomnography (PSG) is considered the gold standard for diagnosis. The aim of the present study is to assess the prevalence of nocturnal sleep disorders diagnosed by polysomnography and to determine the associated clinical factors. Method: A total of 120 patients with Parkinson's disease were included. All patients underwent a standardized overnight, single night polysomnography. Results: Ninety-four (78.3%) patients had an abnormal PSG. Half of the patients fulfilled criteria for sleep apnea-hypopnea syndrome (SAHS); rapid eye movement behavior disorder (RBD) was present in 37.5%. Characteristics associated with SAHS were age (p = 0.049) and body mass index (p = 0.016). Regarding RBD, age (p , 0.001), left motor onset (p = 0.047) and levodopa equivalent dose (p = 0.002) were the main predictors. Conclusion: SAHS and RBD were the most frequent sleep disorders. Higher levodopa equivalent dose and body mass index appear to be risk factors for RBD and SAHS, respectively.Keywords: Parkinson's disease, sleep disorders, polysomnography. RESUMOObjetivo: Os distúrbios do sono na doença de Parkinson são muito comuns. A polissonografia é considerada o padrão-ouro para o diagnóstico. O objetivo do presente estudo é avaliar a prevalência de distúrbios de sono noturno diagnosticados por polissonografia. Método: 120 pacientes com doença de Parkinson foram incluídos. Todos os pacientes foram submetidos a uma única noite, polissonografia de noite. Resultados: 94 (78,3%) pacientes tiveram uma polissonografia anormal e 50% preencheram a síndrome da apneia e hipopneia do sono (SAHOS); distúrbio de comportamento do movimento rápido dos olhos (RBD) esteve presente em 37,5%. As características associadas com SAHOS foram idade (p = 0,049) e índice de massa corporal (p = 0,016). Quanto RBD, idade (p , 0,001), deixou início motor (p = 0,047) e levodopa dose equivalente (p = 0,002) foram os preditores. Conclusão: SAHOS e RBD foram os distúrbios do sono mais frequente. Dose superior equivalente de levodopa e índice de massa corporal parecem ser fatores de risco, respectivamente.Palavras-chave: doença de Parkinson, distúrbios do sono, polissonografia.

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Section: Discussioncontrasting

confidence: 71%

Prevalence and correlates of sleep disorders in Parkinson’s disease: a polysomnographic study

Alatriste-Booth

Rodríguez-Violante

Camacho-Ordóñez

et al. 2015

Arq. Neuro-Psiquiatr.

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“…The incidence of lower urinary tract dysfunction is estimated to be as high as 30% in patients with PD 3 16 . The etiology of this dysfunction is largely unknown, although it is often associated with significantly decreasing quality of life 16,17 . Previous functional brain imaging studies have shown some overlaps as well as differences in brain activation sites during bladder filling between healthy volunteers and patients with PD who had detrusor overactivity 18 .…”

Section: Discussionmentioning

confidence: 99%

Role of the Anterior Cingulate Cortex in the Control of Micturition Reflex in a Rat Model of Parkinson's Disease

et al. 2016

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“…NMS represent some of the leading causes of disability and impairment in QoL in PD, therefore, the recognition of these aspects of the disease is essential to provide care that can potentially induce a decisive and comprehensive impact in these cases 10 . Despite its importance and frequency, NMS are not adequately recognized in clinical practice.…”

Section: Prevalence and Impact Of Non-motor Signs Of Parkinson's Diseasementioning

confidence: 99%

Non-motor signs in Parkinson’s disease: a review

Munhoz

Moro

Silveira‐Moriyama

et al. 2015

Arq. Neuro-Psiquiatr.

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The traditional pathological description of PD as a pre-synaptic degenerative process affecting dopaminergic neurons in the substantia nigra pars compacta (SNc) of the midbrain with formation of Lewy bodies (LB) has changed dramatically in the last decade since functional and neuropathological studies showed the occurrence of extensive extranigral involvement 1 . Among these investigations, the seminal study of Braak et al. 2 suggested that the degenerative process in the PD starts in the caudal regions of the brainstem and the olfactory bulb, progressing in the caudal-rostral direction. The involvement of the SNc occurs, according to this hypothesis, on the third of a six-stage process that begins in the dorsal motor nuclei of the glossopharyngeal and vagus nerves and the olfactory bulb. Although it demonstrates the occurrence of this peculiar pathological distribution, the study fails to make the clinical correlation between any of these changes and motor or non-motor manifestations. On the other hand, even considering this caveat, it was one of the studies that formed the basis and motivated the dissemination of the concept of the existence of non-motor signs (NMS), especially dysautonomia, olfaction and sleep disorders, as part of the disease, sometimes even preceding the classic motor symptoms of PD.The motor aspects of PD typically have a slow progression and direct correlation with the presence of neuronal degeneration in the SNc, but they do not represent the actual beginning of the degenerative process. This process is, in fact, in full progression, despite been apparently silent when one seeks only for motor signs 3 . EXTRANIGRAL DEGENERATIONThe notion of PD as a multisystemic disease, not restricted to the nigrostriatal tract is not new, however the cited ABSTRACTDuring the past decade the view of Parkinson's disease (PD) as a motor disorder has changed significantly and currently it is recognized as a multisystem process with diverse non-motor signs (NMS). In addition to been extremely common, these NMS play a major role in undermining functionality and quality of life. On the other hand, NMS are under recognized by physicians and neglected by patients. Here, we review the most common NMS in PD, including cognitive, psychiatric, sleep, metabolic, and sensory disturbances, discuss the current knowledge from biological, epidemiological, clinical, and prognostic standpoints, highlighting the need for early recognition and management.Keywords: Parkinson's disease, non-motor signs, dementia, hyposmia, psychosis. RESUMONo decorrer da última década, a visão da doença de Parkinson (DP) como um distúrbio de movimento puro mudou significativamente, sendo atualmente reconhecida como um processo multisistêmico com diversos sinais não motores (SNM). Além de serem extremamente comuns, estes SNM têm um impacto muito significativo na limitacão funcional e da qualidade de vida na DP. Por outro lado, os SNM são mal reconhecidos pelos clínicos e negligenciados pelos pacientes. Nessa revisão os SNM mais comuns na DP fo...

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Non-motor symptoms of Parkinson's disease: diagnosis and management

Cited by 2,277 publications

References 121 publications

Prevalence and correlates of sleep disorders in Parkinson’s disease: a polysomnographic study

Prevalence and correlates of sleep disorders in Parkinson’s disease: a polysomnographic study

Role of the Anterior Cingulate Cortex in the Control of Micturition Reflex in a Rat Model of Parkinson's Disease

Non-motor signs in Parkinson’s disease: a review

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