Skip to main content

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

Acta Neurologica Belgica volume 117, pages 207–211 (2017)Cite this article

Abstract

Autonomic dysfunctions are part of a spectrum of non-motor symptoms in Parkinson’s disease (PD) patients. The aim of the study was to assess the prevalence of autonomic dysfunctions and their influence on the quality of life (QoL) in PD patients, adjusted for age, sex, disease duration and motor symptoms. Patients were evaluated for motor function (Unified Parkinson’s Disease Rating Scale, UPDRS part III), disease stage (Hoehn and Yahr scale, H&Y scale), autonomic dysfunction (Scales for Outcomes in Parkinson’s disease, Autonomic, SCOPA-AUT) and QoL (Parkinson’s Disease Questionnaire-39, PDQ-39). Urinary, gastrointestinal and sexual autonomic dysfunctions were most frequently reported, while the most severe symptoms were reported for sexual and urinary systems. Age and motor symptoms did not correlate with autonomic dysfunction, while disease duration correlated with cardiovascular dysfunction. There were sex differences on the thermoregulation subscale. All types of autonomic dysfunction influenced QoL, mostly gastrointestinal and thermoregulatory dysfunctions, except for sexual one. Many aspects of QoL (activity of daily living, emotion, cognitive functions, communication and social support) except for stigma and mobility were affected by autonomic dysfunctions. Age, disease duration, sex and motor symptoms were not found to affect global QoL scores, but had detrimental effects on different PDQ-39 dimensions. Autonomic dysfunctions influence QoL in more aspects than motor symptoms, age, disease duration and sex. Patients tend to be more stigmatized with motor than non-motor symptoms.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

USD 39.95

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

References

  1. Micieli G, Tosi P, Marcheselli S, Cavallini A (2003) Autonomic dysfunction in Parkinson’s disease. Neurol Sci 24(1):S32–S34

    Article  PubMed  Google Scholar 

  2. Jost WH (2003) Autonomic dysfunctions in idiopathic Parkinson’s disease. J Neurol 250(1):i28–i30

    Article  PubMed  Google Scholar 

  3. Li K, Reichmann H, Ziemssen T (2015) Recognition and treatment of autonomic disturbances in Parkinson’s disease. Expert Rev Neurother 15(10):1189–1203

    Article  CAS  PubMed  Google Scholar 

  4. Liepelt-Scarfone I, Pilotto A, Müller K, Bormann C, Gauss K, Wurster I, Streffer J, Berg D (2015) Autonomic dysfunction in subjects at high risk for Parkinson’s disease. J Neurol 262(12):2643–2652

    Article  CAS  PubMed  Google Scholar 

  5. van Uem JM, Marinus J, Canning C, van Lummel R, Dodel R, Liepelt-Scarfone I, Berg D, Morris ME, Maetzler W (2015) Health-related quality of life in patients with Parkinson’s—a systematic review based on the ICF model. Neurosci Biobehav Rev 61:26–34

    PubMed  Google Scholar 

  6. Prakash KM, Nadkarni NV, Lye WK, Yong MH, Tan EK (2016) The impact of non-motor symptoms on the quality of life of Parkinson’s disease patients: a longitudinal study. Eur J Neurol 23(5):854–860

    Article  CAS  PubMed  Google Scholar 

  7. 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 Psychiatry 55:181–184

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Visser M, Marinus J, Stiggelbout AM, Van Hilten JJ (2004) Assessment of autonomic dysfunction in Parkinson’s disease: the SCOPA-AUT. Mov Disord 19(11):1306–1312

    Article  PubMed  Google Scholar 

  9. Hagell P, Nygren C (2007) The 39 item Parkinson’s Disease Questionnaire (PDQ-39) revisited: implications for evidence based medicine. J Neurol Neurosurg Psychiatry 78:1191–1198

    Article  PubMed  PubMed Central  Google Scholar 

  10. Gołab-Janowska M, Budzianowska A, Honczarenko K (2011) Autonomic disorders in Parkinson’s disease. Ann Acad Med Stetin 57(1):11–15

    PubMed  Google Scholar 

  11. Sakakibara R, Shinotoh H, Uchiyama T et al (2001) Questionnaire-based assessment of pelvic organ dysfunction in Parkinson’s disease. Auton Neurosci 92(1–2):76–85

    Article  CAS  PubMed  Google Scholar 

  12. De Luka SR, Svetel M, Pekmezović T, Milovanović B, Kostić VS (2014) When do the symptoms of autonomic nervous system malfunction appear in patients with Parkinson’s disease? Vojnosanit Pregl 71(4):346–351

    Article  PubMed  Google Scholar 

  13. Goldstein DS (2014) Dysautonomia in Parkinson disease. Compr Physiol 4(2):805–826

    PubMed  Google Scholar 

  14. van Rooden SM, Verbaan D, Stijnen T, Marinus J, van Hilten JJ (2016) The influence of age and approaching death on the course of nondopaminergic symptoms in Parkinson’s disease. Parkinsonism Relat Disord 24:113–118

    Article  PubMed  Google Scholar 

  15. Chaudhuri KR, Healy DG, Schapira AH (2006) Nonmotor symptoms of Parkinson’s disease: diagnosis and management. Lancet Neurol 5(3):235–245

    Article  PubMed  Google Scholar 

  16. Gallagher DA, Lees A, Schrag A (2010) What are the most important nonmotor symptoms in patients with Parkinson’s disease and are we missing them? Mov Disord 25(15):2493–2500

    Article  PubMed  Google Scholar 

  17. Merola A, Romagnolo A, Rosso M, Lopez-Castellanos JR, Wissel BD, Larkin S, Bernardini A, Zibetti M, Maule S, Lopiano L, Espay AJ (2016) Orthostatic hypotension in Parkinson’s disease: does it matter if asymptomatic? Parkinsonism Relat Disord 33:65–71

    Article  PubMed  Google Scholar 

  18. Swinn L, Schrag A, Viswanathan R, Bloem BR, Lees A, Quinn N (2003) Sweating dysfunctions in Parkinson’s disease. Mov Disord 18(12):1459–1463

    Article  PubMed  Google Scholar 

  19. Hristova DR, Hristov JI, Mateva NG, Papathanasiou JV (2009) Quality of life in patients with Parkinson’s disease. Folia Med (Plovdiv) 51(4):58–64

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Clinical Department of Neurology, Osijek University Hospital Center, J. Huttlera 4, 31000, Osijek, Croatia

    Svetlana Tomic, Vlasta Pekic & Sanja Misevic

  2. School of Medicine, Josip Juraj Strossmayer University, J. Huttlera 4, Osijek, Croatia

    Svetlana Tomic, Ines Rajkovaca, Vlasta Pekic & Tamer Salha

  3. Clinical Department of Radiology, Osijek University Hospital Center, J. Huttlera 4, Osijek, Croatia

    Tamer Salha

Authors
  1. Svetlana Tomic
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ines Rajkovaca
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Vlasta Pekic
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Tamer Salha
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Sanja Misevic
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Svetlana Tomic.

Ethics declarations

Conflict of interest

Author A received honoraria from Fresenius d.o.o., Pliva Hrvatska d.o.o., Medis d.o.o; and received financial support for attending symposia from Abbvie d.o.o. and Medis d.o.o. Authors B, C and D have no conflict of interest. Author E received honoraria from Novartis.

Ethical standards

The study was approved by the Hospital Ethics Committee.

Funding

None.

Informed consent

Prior to study entry, they provided their informed consent.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Tomic, S., Rajkovaca, I., Pekic, V. et al. Impact of autonomic dysfunctions on the quality of life in Parkinson’s disease patients. Acta Neurol Belg 117, 207–211 (2017). https://doi.org/10.1007/s13760-016-0739-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13760-016-0739-6

Keywords

  • Autonomic dysfunctions
  • Parkinson’s disease
  • Quality of life
  • SCOPA-AUT
  • PDQ-39