Objective: To determine the profile of AS and the relationship to motor severity and phenotype in persons with PD in Nigeria.

Background: Autonomic symptoms (AS) are frequent, non-motor manifestations of Parkinson’s disease (PD) with a wide spectrum spanning  gastrointestinal, urinary, cardiovascular, thermoregulatory, pupillomotor, and sexual domains. AS occur throughout the course of PD, contributing significantly to the overall disease burden.

Method: The Nigeria Parkinson’s Disease Research (NPDR) network has an ongoing nationwide clinical PD registry. PD is defined using the United Kingdom PD Brain Bank criteria, and demographic, clinical, and disease-specific motor and non-motor variables are documented at baseline enrolment. We report the burden of AS based on the SCOPA-AUT questionnaire, and its relationship to the MDS UPDRS Part III score, Hoehn & Yahr (H&Y) stage, and Stebbins motor phenotype.

Results: We present data for 1808 persons with PD (pwPD) comprised of 494 (27.3%) females and 1314 (72.7%) males. Mean age at study was 63.8 (SD 10.1) years (range 23–96 years), mean age at onset was 59.5 (SD 10.4) years, and median H&Y stage was 2.0 (IQR 1.0). The distribution of motor phenotypes was: tremor-dominant (TD) – 1018, 56.3%; postural instability and gait difficulty (PIGD)-555 (30.7%); and indeterminate (ID) – 235 (13.0%). Mean (SD) SCOPA-AUT scores were: total (9.2 ± 6.7; median 8.0); gastrointestinal (2.9 ± 2.8; median 2.0); urinary (3.2 ±3.0; median 2.0); cardiovascular (0.8 ±1.2; median 0.0); thermoregulatory (0.8 ± 1.6; median 0.0); pupillomotor (0.1±0.4; median 0.0); and sexual dysfunction (males-1.4±1.8, median 0.0; females-0.5±1.3, median 0). Total SCOPA-AUT score significantly (positively) correlated with the H&Y stage (r = 0.279; p <0.001) and motor severity (MDS UPDRS III score; r = 0.329; p <0.001). Total SCOPA-AUT score was highest in PD-PIGD (11.1 ± 7.4; median 10.0) (compared to ID – 9.7 ± 7.1, median 9.0 and TD 8.0 ± 5.8; median 7.0), p<0.001).

Conclusion: Our study corroborates the correlation between PD progression and motor severity and the burden of autonomic features in PD.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/association-of-autonomic-symptoms-with-motor-features-of-parkinsons-disease-in-the-nigeria-parkinsons-disease-research-network-registry/