%0 Journal Article
%T Nonmotor Symptoms in Early- and Advanced-Stage Parkinson¡¯s Disease Patients on Dopaminergic Therapy: How Do They Correlate with Quality of Life?
%A Peter Valkovic
%A Jan Harsany
%A Marta Hanakova
%A Jana Martinkova
%A Jan Benetin
%J ISRN Neurology
%D 2014
%R 10.1155/2014/587302
%X To determine the impact of nonmotor symptoms (NMS) on health-related quality of life (HRQoL) we examined 100 Parkinson¡¯s disease (PD) patients on dopaminergic medications. An ¡°early-stage¡± (ES) and an ¡°advanced-stage¡± (AS) groups were formed. HRQoL was established by the questionnaire PDQ-8, number of NMS by NMSQuest, and severity and frequency of NMS by the assessment scale NMSS. The total NMS averaged 11.3 , . The NMSS domain correlation profiles for ES and AS did not fundamentally differ; however, the domains attention/memory and mood/apathy correlated moderately to strongly with HRQoL in ES, while the sleep/fatigue domain correlated moderately with HRQoL in AS. Weakly correlating domains were sleep/fatigue in ES and cardiovascular, attention/memory, and mood/apathy domains in AS. In view of these findings we strongly recommend systematic, active screening and therapy for neuropsychiatric disorders (mood, cognitive and sleep disorders, and fatigue) at the initial diagnosis and throughout the entire course of PD. 1. Introduction Parkinson¡¯s disease (PD) is a progressive, complex disorder characterized by motor symptoms (bradykinesia, rigidity, resting tremor, and postural instability) as well as a wide range of nonmotor symptoms (NMS) that contribute to significant morbidity and disability [1, 2]. It is important to identify those NMS that most influence the patient¡¯s life, since they may not be evident during the clinical examination [3]. NMS like depression, anxiety, cognitive decline, pain, fatigue, insomnia, and autonomic dysfunction (constipation, urinary symptoms) are significant factors that diminish health-related quality of life (HRQoL) of individuals with PD [4¨C6]. While common, they are still often underrecognized in clinical practice because patients fail to spontaneously mention them, and healthcare professionals also fail to systematically ask about them [5, 7]. Nonmotor symptoms occur not only in advanced but also in early stages of PD. Some symptoms, for example, olfactory deficit, constipation, rapid-eye movement sleep behavior disorder, and depression, can even precede the appearance of motor symptoms by many years [8]. Most of the PD-associated NMS are believed to be caused by the nondopaminergic systems, in accordance with the hypothesis that other neurotransmitters including serotoninergic, noradrenergic, and cholinergic transmission are involved [9]. However, in a recent study on advanced PD subjects, Storch and coworkers [10] showed that seven out of ten selected NMS (with the exception of dysphagia, excessive sweating, and
%U http://www.hindawi.com/journals/isrn.neurology/2014/587302/