Objective: To assess nocturnal hypokinesia and its relationship with clinical features and quality of life (QoL) in patients with Parkinson’s disease (PD).

Background: The nocturnal hypokinesia referred to as difficulties in rolling in the bed, is common in Parkinson’s disease (PD), observed in more than half of PD patients. The nocturnal hypokinesia is not solely contributed to night-time aggravation of parkinsonism, it is also associated with poor sleep quality and QoL in PD patients. Therefore, screening and assessing the severity of nocturnal hypokinesia may be valuable for patients with PD.

Method: We assessed nocturnal hypokinesia in a representative sample of PD patients from three referral hospitals during a study period of 1-year. We used the Korean version of the Nocturnal Hypokinesia Questionnaire (NHQ-K) that showed satisfactory internal consistency (0.83) and inter-rater reliability (0.95). We also evaluated the patients’ clinical features and QoL using the Movement Disorder Society Unified PD Rating Scale (MDS-UPDRS) and 39-item PD Questionnaire (PDQ-39).

Results: A total of 108 patients completed the NHQ-K, and sixty-four (59.3%) of them had nocturnal hypokinesia. The most frequent nocturnal symptom in patients with nocturnal hypokinesia was difficulty getting out of bed (95.3%), followed by turning-over difficulty (87.5%). Multivariate regression analysis revealed that NHQ-K scores increased significantly along with severity of parkinsonian motor symptoms as indicated by the Hoehn and Yahr stage and the MDS-UPDRS part II total score, also with PD-related QoL score and educational year (p <0.05). The NHQ-K score was also positively and significantly related to the MDS-UPDRS part I subitem anxious mood and constipation scores, part IV subitem off disability score, and PDQ-39 subitem mobility, emotional well-being, stigma, and bodily discomfort scores (p <0.05), adjusting for age, gender, and co-factors of parkinsonian motor severity, dopaminergic drugs, education, and global cognition score.

Conclusion: Nocturnal hypokinesia is common in PD patients. Non-motor symptoms and poor QoL are significant associates of nocturnal hypokinesia besides parkinsonian motor severity.

References: [1] M. Louter, M. Munneke, B.R. Bloem, S. Overeem, Nocturnal hypokinesia and sleep quality in Parkinson’s disease, Journal of the American Geriatrics Society 60(6) (2012) 1104-8. [2] R. Bhidayasiri, P. Mekawichai, O. Jitkritsadakul, P. Panyakaew, L. Kaewwilai, N. Boonrod, S. Petchrutchatachart, P. Jagota, K. Boonpeng, S. Singmaneesakulchai, S. Setthawatcharawanich, Nocturnal journey of body and mind in Parkinson’s disease: the manifestations, risk factors and their relationship to daytime symptoms. Evidence from the NIGHT-PD study, Journal of neural transmission (Vienna, Austria : 1996) 121 Suppl 1 (2014) S59-68. [3] J. Sringean, P. Taechalertpaisarn, C. Thanawattano, R. Bhidayasiri, How well do Parkinson’s disease patients turn in bed? Quantitative analysis of nocturnal hypokinesia using multisite wearable inertial sensors, Parkinsonism & related disorders 23 (2016) 10-6. [4] J. Sringean, C. Anan, C. Thanawattano, R. Bhidayasiri, Time for a strategy in night-time dopaminergic therapy? An objective sensor-based analysis of nocturnal hypokinesia and sleeping positions in Parkinson’s disease, Journal of the neurological sciences 373 (2017) 244-248. [5] M. Louter, W. Maetzler, J. Prinzen, R.C. van Lummel, M. Hobert, J.B. Arends, B.R. Bloem, J. Streffer, D. Berg, S. Overeem, I. Liepelt-Scarfone, Accelerometer-based quantitative analysis of axial nocturnal movements differentiates patients with Parkinson’s disease, but not high-risk individuals, from controls, Journal of neurology, neurosurgery, and psychiatry 86(1) (2015) 32-7. [6] E.L. Stack, A.M. Ashburn, Impaired bed mobility and disordered sleep in Parkinson’s disease, Movement disorders : official journal of the Movement Disorder Society 21(9) (2006) 1340-2. [7] R. Bhidayasiri, O. Phokaewvarangkul, J. Sringean, P. Martinez-Martin, C. Anan, N. Kantachadvanich, K.R. Chaudhuri, N. Hattori, Evaluation of nocturnal hypokinesia in Parkinson’s disease using a novel patient/proxy questionnaire and correlations with objective monitoring, Parkinsonism & related disorders 61 (2019) 219-223.

« Back to MDS Virtual Congress 2020

MDS Abstracts - https://www.mdsabstracts.org/abstract/value-of-nocturnal-hypokinesia-screening-concerning-the-quality-of-life-and-clinical-features-in-parkinsons-disease/