Journal of Neurology

, Volume 260, Issue 1, pp 131–137 | Cite as

Prevalence of non-motor symptoms in young-onset versus late-onset Parkinson’s disease

  • Vladana Špica
  • Tatjana Pekmezović
  • Marina Svetel
  • Vladimir S. Kostić
Original Communication

Abstract

Non-motor symptoms (NMS) of Parkinson’s disease (PD) have only recently been increasingly recognized for their impact on a patient’s quality of life. In this study, we applied the validated, comprehensive self-completed NMS questionnaire for PD (NMS Quest) to 101 patients with young-onset PD (onset between 21 and 45 years, YOPD) and 107 patients with late-onset PD (onset of PD ≥ 55 years, LOPD). The mean total NMS (NMSQ-T) was 11.9 ± 6.0 (range: 0 to of a maximum of 26) in LOPD and 7.7 ± 5.8 (range: 0 to of a maximum of 26) in YOPD (p < 0.05). Compared to YOPD, dribbling of saliva, loss of taste/smell, nocturia, forgetfulness, loss of interest, hallucinations, lack of concentration, anxiety, change in libido and difficulty in sexual activities, were significantly more prevalent in LOPD. The only NMS more prevalent in YOPD were restless legs and sweating, although such findings might be associated with drug effects. Among the nine NMS Quest domains, in both LOPD and YOPD patients the three most prevalent domains were depression/anxiety, urinary and sexual. Also, in both groups, hallucinations/delusions had the lowest frequency. In the multivariate linear regression model, the Hoehn and Yahr (HY) stage of the disease and activities of daily living scores in YOPD patients, while only the HY stage in LOPD patients appeared to be statistically significant predictors of increasing number of NMS. In contrast to a previous suggestion that YOPD patients might have an increased risk for NMS, we found a higher prevalence of NMS in LOPD patients than in those with YOPD.

Keywords

Non-motor symptoms Young-onset Parkinson’s disease 

Notes

Acknowledgments

This study was supported by a grant from the Ministry of Science and Technology (MST), Republic of Serbia (projects no. 175090).

Conflicts of interest

Tha authors declared that they have no conflict of interest.

Ethical standard

All human studies must state that they have been approved by the appropriate ethics committe and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki.

References

  1. 1.
    Quinn N, Critchley P, Marsden CD (1987) Young-onset Parkinson’s disease. Mov Disord 2:73–91PubMedCrossRefGoogle Scholar
  2. 2.
    Schrag A, Schott JM (2006) Epidemiological, clinical and genetic characteristics of early onset Parkinsonism. Lancet Neurol 5:355–363PubMedCrossRefGoogle Scholar
  3. 3.
    Diamond SG, Markham CH, Hoehn MM, McDowell FH, Muenter MD (1989) Effect of age at onset on progression and mortality in Parkinson’s disease. Neurology 39:1187–1190PubMedCrossRefGoogle Scholar
  4. 4.
    Kidron D, Melamed E (1987) Forms of dystonia in patients with Parkinson’s disease. Neurology 37:1009–1011PubMedCrossRefGoogle Scholar
  5. 5.
    Schrag A, Ben Shlomo Y, Brown R, Marsden CD, Quinn N (1998) Young-onset Parkinson’s disease revisited–clinical features, natural history, and mortality. Mov Disord 13:885–894PubMedCrossRefGoogle Scholar
  6. 6.
    Kostić VS, Filipovic SR, Lecic D, Momcilovic D, Sokic D, Sternic N (1994) Effect of age at onset on frequency of depression in Parkinson’s disease. J Neurol Neurosurg Psychiatr 57:1265–1267PubMedCrossRefGoogle Scholar
  7. 7.
    Wickremaratchi MM, Ben-Shlomo Y, Morris HR (2009) The effect of onset age on the clinical features of Parkinson’s disease. Eur J Neurol 6:450–456CrossRefGoogle Scholar
  8. 8.
    Kostić VS, Przedborski S, Flaster E, Sternic N (1991) Early development of levodopa-induced dyskinesias and response fluctuations in young-onset Parkinson’s disease. Neurology 41:202–205PubMedCrossRefGoogle Scholar
  9. 9.
    Martinez-Martin P, Rodriguez-Blazquez BS, Kurtis MM, Chaudhuri KR, on behalf of the NMSS Validation Group (2011) The impact of non-motor symptoms on health-related quality of life of patients with Parkinson’s disease. Mov Disord 26:399–406CrossRefGoogle Scholar
  10. 10.
    Chaudhuri KR, Schapira AH (2009) Non-motor symptoms of Parkinson’s disease: dopaminergic pathophysiology and treatment. Lancet Neurol 8:464–474PubMedCrossRefGoogle Scholar
  11. 11.
    Shulman LM, Taback RL, Rabinstein AA, Weiner WJ (2002) Non-recognition of depression and other non-motor symptoms in Parkinson’s disease. Parkinsonism Relat Disord 8:193–197PubMedCrossRefGoogle Scholar
  12. 12.
    Clarke CE, Zobkiw RM, Gullaksen E (1995) Quality of life and care in Parkinson’s disease. Br J Clin Pract 49:288–293PubMedGoogle Scholar
  13. 13.
    Chaudhuri KR, Martinez-Martin P, Schapira AH, Stocchi F, Sethi K, Odin P, Brown RG, Koller W, Barone P, MacPhee G, Kelly L, Rabey M, MacMahon D, Thomas S, Ondo W, Rye D, Forbes A, Tluk S, Dhawan V, Bowron A, Williams AJ, Olanow CW (2006) International multicenter pilot study of the first comprehensive self-completed non-motor symptoms questionnaire for Parkinson’s disease: the NMS Quest study. Mov Disord 21:916–923PubMedCrossRefGoogle Scholar
  14. 14.
    Hoehn MM, Yahr MD (1967) Parkinsonism: onset, progression and mortality. Neurology 17:427–442PubMedCrossRefGoogle Scholar
  15. 15.
    Evans AH, Katzenschlager R, Paviour D, O’Sullivan JD, Appel S, Lawrence AD, Lees AJ (2004) Punding in Parkinson’s disease: its relation to the dopamine dysregulation syndrome. Mov Disord 19:397–405PubMedCrossRefGoogle Scholar
  16. 16.
    Hughes AJ, Daniel SE, Kilford L, Lees AJ (1992) Accuracy of clinical diagnosis of idiopathic Parkinson’s disease: a clinico-pathological study of 100 cases. J Neurol Neurosurg Psychiatr 55:181–184PubMedCrossRefGoogle Scholar
  17. 17.
    Folstein MF, Folstein SE, McHugh PR (1975) “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12:189–198PubMedCrossRefGoogle Scholar
  18. 18.
    Fahn S, Elton RL, UPDRS program members (1987) Unified Parkinson’s disease rating scale. In: Fahn S, Marsden CD, Goldstein M, Calne DB (eds) Recent developments in Parkinson’s disease, vol 2. Macmillan Healthcare Information, Florham Park, pp 153–163Google Scholar
  19. 19.
    Hamilton M (1960) A rating scale for depression. J Neurol Neurosurg Psychiatr 23:56–62PubMedCrossRefGoogle Scholar
  20. 20.
    Hamilton M (1959) The assessment of anxiety states by rating. Br J Med Psychol 32:50–55PubMedCrossRefGoogle Scholar
  21. 21.
    Calne SM, Kumar A (2008) Young-onset Parkinson’s disease. Practical management of medical issues. Parkinsonism Relat Disord 14:133–142PubMedCrossRefGoogle Scholar
  22. 22.
    Hwynn N, Haq IU, Malaty IA, Resnick AS, Okun MS, Carew DS, Oyama G, Dai Y, Wu SS, Rodriguez RL, Jacobson CE, Fernandez HH (2011) The frequency on non-motor symptoms among advanced Parkinson patients may depend on instrument used for assessment. Parkinson’s Dis. doi: 10.4061/2011/290195 Google Scholar
  23. 23.
    Chaudhuri KR, Martinez-Martin P, Brown RG, Sethi K, Stocchi F, Odin P, Ondo W, Abe K, Macphee G, Macmahon D, Barone P, Rabey M, Forbes A, Breen K, Tluk S, Naidu Y, Olanow W, Williams AJ, Thomas S, Rye D, Tsuboi Y, Hand A, Schapira AH (2007) The metric properties of a novel non-motor symptoms scale for Parkinson’s disease: results from an international pilot study. Mov Disord 22:1901–1911PubMedCrossRefGoogle Scholar
  24. 24.
    Martinez-Martin P, Schapira AH, Stochi F, Sethi K, Odin P, MacPhee G, Brown RG, Naidu Y, Clayton L, Abe K, Tsuboi Y, MacMahon D, Barone P, Rabey M, Bonuccelli U, Forbes A, Breen K, Tluk S, Olanow CW, Thomas S, Rye D, Hand A, Williams AJ, Ondo W, Chaudhuri KR (2007) Prevalence of non-motor symptoms in Parkinson’s disease in an international setting: study using non-motor symptom questionnaire in 545 patients. Mov Disord 22:1623–1629PubMedCrossRefGoogle Scholar
  25. 25.
    Kaji G, Klein C, Wood NW, Schneider SA, Pramstaller PP, Tadic V, Quinn NP, van de Warrenburg BPC, Bhatia KP (2010) Non-motor symptoms in Parkin gene-related parkinsonism. Mov Disord 25:1279–1284CrossRefGoogle Scholar
  26. 26.
    Bassetti CL (2011) Non-motor symptoms in Parkinson’s disease. Neurodegner Dis 8:95–108CrossRefGoogle Scholar
  27. 27.
    Peralta CM, Frauscher B, Seppi K, Wolf E, Wenning GK, Hogl B, Poewe W (2009) Restless legs syndrome in Parkinson’s disease. Mov Disord 24:2076–2080PubMedCrossRefGoogle Scholar
  28. 28.
    Gomez-Esteban JC, Zarranz JJ, Tijero B, Velasco F, Barcena J, Rouco I, Lezcano E, Lachen MC, Jauregui A, Ugarte A (2007) Restless legs syndrome in Parkinson’s disease. Mov Disord 22:1912–1916PubMedCrossRefGoogle Scholar
  29. 29.
    Lee JE, Shin H-W, Kim KS, Sohn YH (2009) Factors contributing to the development of restless legs syndrome in patients with Parkinson disease. Mov Disord 24:579–582PubMedCrossRefGoogle Scholar
  30. 30.
    Verbaan D, van Rooden SM, van Hilten JJ, Rijsman RM (2010) Prevalence and clinical profile of restless legs syndrome in Parkinson’s disease. Mov Disord 25:2142–2147PubMedCrossRefGoogle Scholar
  31. 31.
    Park A, Stacy M (2009) Non-motor symptoms in Parkinson’s disease. J Neurol 256(Suppl 3):S293–S298CrossRefGoogle Scholar
  32. 32.
    Goldstein DS, Sewell L, Holmes C (2010) Association of anosmia with autonomic failure in Parkinson disease. Neurology 74:245–251PubMedCrossRefGoogle Scholar
  33. 33.
    Bassetti CL (2011) Non-motor disturbances in Parkinson’s disease. Neurodegener Dis 8:95–108PubMedCrossRefGoogle Scholar
  34. 34.
    Gallagher DA, Lees AJ, Schrag A (2010) What are the most important non-motor symptoms in patients with Parkinson’s disease and are we missing them? Mov Disord 25:2493–2500PubMedCrossRefGoogle Scholar
  35. 35.
    Schrag A, Hovris A, Morley D, Quinn N, Jahanshahi M (2003) Young- versus older-onset Parkinson’s disease: impact of disease and psychosocial consequences. Mov Disord 18:1250–1256PubMedCrossRefGoogle Scholar
  36. 36.
    Braak H, Del Tredici K, Rub U, de Vos RAI, Jansen Steur ENH, Braak E (2003) Staging of brain pathology related to sporadic Parkinson’s disease. Neurobiol Aging 24:197–210PubMedCrossRefGoogle Scholar
  37. 37.
    Chaudhuri KR, Healy DG, Schapira AHV (2006) Non-motor symptoms of Parkinson’s disease: diagnosis and management. Lancet Neurol 5:235–245PubMedCrossRefGoogle Scholar
  38. 38.
    Barone P, Antonini A, Colosimo C, Marconi R, Morgante L, Avarello TP, Bottacchi E, Cannas A, Ceravolo G, Ceravolo R, Cicarelli G, Gaglio RM, Giglia RM, Iemolo F, Manfredi M, Meco G, Nicoletti A, Pederzoli M, Petrone A, Pisani A, Pontieri FE, Quatrale R, Ramat S, Scala R, Volpe G, Zappulla S, Bentivoglio AR, Stocchi F, Trianni G, Dotto PD; PRIAMO study group (2009) The Priamo Study: a multicenter assessment of non-motor symptoms and their impact on quality of life in Parkinson’s disease. Mov Disord 24:1641–1649CrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Vladana Špica
    • 1
  • Tatjana Pekmezović
    • 2
  • Marina Svetel
    • 1
  • Vladimir S. Kostić
    • 1
  1. 1.Institute of Neurology CCS, School of MedicineUniversity of BelgradeBelgradeSerbia
  2. 2.Institute of Epidemiology, School of MedicineUniversity of BelgradeBelgradeSerbia

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