Objective: Investigate existence and evidence of the nonmotor disorders, particularly neuropsychological disorders and autonomic dysfunctions in PD and vascular Parkinsonism patients.

Background: Nonmotor disorders accompany Parkinson disease (PD) on every stage of development, when on advanced stages assumes dominating significance in clinical semiology, causing a great impact on patients’ life-quality. 

Methods: 31 Parkinsonism patients were studied (18 females, 13 males), where 23 suffered from PD, and 8 – vascular Parkinsonism. Average age – 64.42 ±1,1  years, disease complexity by Hoehn and Yahr – 2,5±0.8. Parkinsonism and PD were diagnosed with accordance to clinical diagnostic criteria. Patients were studied by clinical, bedside examination, somatic and neurological status check, autonomic functions tests, neuropsychological tests with MMSE and MoCA scale, Zung Self-Rating Depression scale, and anxiety scale; instrumental examination (ECG, brain  MRI). Statistical analysis is done by SPSS.

Results: Average depression level – 52,7±7,3, when 68 % of the patients suffered mild and moderate depression. 56% Parkinsonism patients suffered increased level of anxiety. Cognitive disorders analysis (MMSE, MoCA): mild and moderate cognitive disorders in ??% of PD; when 6% of vascular Parkinsonism patients had moderate and severe cognitive disorders. 72% suffered sleep disorders, with some cases of daytime sleepiness. The symptoms of dysautonomia observed in 78% of PD patients. 35% cases revealed orthostatic hypotension, and 30% indicated extended QT on ECG. Gastrointestinal symptoms: constipation in 82%, nausea in 20%, hypersalivation in 45.9%. Bladder dysfunction, such as nocturia, urgent and frequent urination were observed in 54.5% of PD patients. Hyperhidrosis revealed in 36.6% cases and oily face and scalp skin in 45.6%.

Conclusions: Severe cognitive disorders were observed in vascular Parkinsonism more often, while mild cognitive disorders were observed in patients with PD. Nonmotor disorders such as depression, anxiety, sleep disorders, autonomic dysfunction are more frequent in PD patients, though still observed in vascular Parkinsonism, which suggests a common development mechanism for these disorders. Revealed data proves the necessity of more detailed and wider range investigation of nonmotor disorders in Parkinson disease and related disorders.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/nonmotor-disorders-in-parkinsonism-experience-in-kyrgyz-republic/