Objective: To determine frequencies of non-motor symptoms (NMS) specifically sleep disorders, fatigue and mood disorders in a cohort of Nigerians with PD seen at the Lagos Movement Disorders Clinic;to determine the relationship between these NMS and PD health-related quality of life.

Background: NMS are now clearly recognized as a major clinical component of PD and have been shown to contribute significantly to quality of life and long-term outcome (1).

Methods: Extract from an on-going cross-sectional study at the Lagos Movement disorder clinic of the Lagos University Teaching Hospital. All consenting consecutively presenting PD were recruited. PD was diagnosed according to the UK PD Society Brain Bank clinical diagnostic criteria. Controls are apparently healthy, age (± 3years) and sex-matched to the cases and recruited from the general population. PD disease severity was assessed using the motor score of the MDS-UPDRS and disease disability documented using the Hoehn and Yahr scale. All were screened for sleep dysfunction using a combination of the PDSS, ESS and the first 4 questions of the PSQI; fatigue was assesed using the fatigue sleep scale (FSS) while mood disorders were assessed using the HADS. PD health-related QoL was documented using the PDQ-8 summary index. PD also had documentation of treatment, levodopa dose, and levodopa response state.

Results: There were 111 PD patients and 41 controls with no significant difference between age of the PD (62.2 ±10.0years) and controls (63.9±11.9years); p>0.05. Male predominance. Mean disease duration was 49.2 ±31.6months. Median Hoehn and Yahr stage was 2. 74% were on levodopa and 89% of these were on at time of study. PDSS score was significantly lower in PD cases (116.6 ±16.8) compared with controls (134.5 ±12.5); p <0.05. There was no significant difference other sleep indices between PD and controls - sleep latency (p > 0.05), sleep duration (p >0.05) and ESS score (p >0.05). FSS score was significantly higher in the PD cases (25.7 ±14.0) than controls (14.0 ±12.6); p =0.000. HADS score was also significantly higher in PD (10.9± 6.0) compared with controls (2.1± 2.5); p = 0.000. Though correlation analysis revealed significant correlation between the PDQ-8 summary index and the PDSS, ESS, FSS, HADS scores and motor score MDS-UPDRS and Hoehn and Yahr score (all significant at 0.01 level), multivariate linear regression analysis showed significance with the FSS score only (p <0.05; 95% C.I 0.04 - 0.78).

Conclusions: Fatigue and mood dysfunction were more common in PD than healthy controls. Fatigue had a positive correlation with the PD health-related quality of life.

References: 1. Martinez-Martin P, Rodriguez Blazquez C, Abe K, Bhattacharyya KB, Bloem B, Carod Artal J et al. International study on the psychometric attributes of the non-motor symptoms scale in Parkinson’s disease. Neurology 2009; 73:1584 – 91.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/sleep-fatigue-and-health-related-quality-of-life-in-a-cohort-of-parkinson-disease-patients/