Objective: This study assessed the frequency of NMS in PD and their relationship with gender, severity and PD motor phenotypes.

Background: Non-motor symptoms (NMS) is one of the major contributors towards disability and impaired quality of life in patients with Parkinson’s disease (PD). NMS distribution between gender, disease phenotype and correlation with severity have been studied sparingly. [1,2]

Method: Patients with PD were assessed for NMS using questionnaire (NMSQuest). [3] Unified Parkinson’s disease rating scale-part III (UPDRS-III) and Hoehn and Yahr (H&Y) staging was done in medication OFF state. Patients were classified into tremor dominant (TD), postural instability and gait dominant (PIGD) or indeterminate motor phenotypes based on UPDRS sub-scores.The frequency of NMS and their relation to severity, stage, and phenotype of PD were analysed.

Results: One forty patients with PD (72% men) with mean age of 57.4±9.6 years were recruited. At least one NMS was present in 97% patients while 45% had more than 10 NMS. Nocturia (54.3%), urinary urgency (47.1%), constipation (45.7%) were common while faecal incontinence (2.1%), delusions (3.6%) were uncommon. Nausea/vomiting, unexplained pain and feeling sad/blue were significantly more often in women while constipation and difficulty having sex were common in men. The total score of NMS questionnaire showed significant positive correlations with duration of symptoms (r=0.424, p<0.01), UPDRS-III OFF score (r=0.410, p<0.01) and H&Y staging (r=0.436, p<0.01). In patients with disease duration of ≤5 years (n=58), PIGD subtype (n=13) had significantly more patients with dribbling of saliva, difficulty concentration, feeling sad/blue, swelling of legs and delusions compared to TD subtype (n=45).

Conclusion: NMS were more often seen with longer duration of illness and severe disease (UPDRS-III OFF score and H&Y stage). Some non-motor symptoms were more commonly seen in PIGD phenotype compared to TD phenotype.

References: 1. Nicoletti A, Vasta R, Mostile G et al. Gender effect on non-motor symptoms in Parkinson’s disease: are men more at risk? Parkinsonism Relat Disord. 2017;35:69-74. 2. Wu Y, Guo XY, Wei QQ et al. Non-motor symptoms and quality of life in tremor dominant vs postural instability gait disorder Parkinson’s disease patients. Acta Neurol Scand. 2016;133:330-7. 3. Chaudhuri KR, Martinez-Martin P. Quantitation of non-motor symptoms in Parkinson’s disease. Eur J Neurol. 2008 Sep;15 Suppl 2:2-7.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/non-motor-symptoms-in-patients-with-parkinsons-disease-effect-of-gender-disease-severity-and-disease-phenotype/