NON-MOTOR SYMPTOMS IN PARKINSON'S DISEASE USING THE EXAMPLE OF AKTOBE PATIENTS
Relevance. Non-motor manifestations in Parkinson's disease (PD) make their debut long before the manifestation of motor disorders. The prevalence of the frequency of non-motor symptoms (NMS) in PD ranges from 70 to 100% of patients. Common NMS in PD include: cognitive impairment, hyposmia, rapid eye movement (REM-rapid eye movement), sleep behavior disorder (RBD-REM sleep behavior disorder), depression, constipation and urination disorders. Timely diagnosis of NMS in PD contributes to early therapeutic correction. This article discusses NMS in Parkinson's disease in patients of the city of Aktobe.
The aim of study: to investigate the frequency, structure and severity of NMS in patients at various stages of PD.
Materials and methods: This study is a fragment of the dissertation work "Immunohistochemical markers of degenerative diseases of the nervous system". Study design: single-stage transverse. The study was conducted from May 2019 to June 2021. The study was approved at the meeting of the local Ethics Committee of the West Kazakhstan Medical University in Aktobe, Protocol No. 4 of May 17, 2019. The 1st part of the MDS-UPDRS scale-non-motor aspects of everyday life (nM-EDL) was used to evaluate the NMS. This part of the scale evaluates the effect of non-motor symptoms of Parkinson's disease on the daily activity of patients. The following statistical criteria were used: Shapiro-Wilka, descriptive statistics: median Me, lower and upper quartile, standard deviation. Correlation analysis was performed using Spearman's nonparametric criterion for two linear variables.
Results and discussion:
1. All patients with PD have mild NMS with an average score of 7.5 on the MDS UPDRS-1 scale.
2. Of all the NMS, cognitive impairment (89.5%) and anxiety (89.5%) were more pronounced; the symptoms of dopamine regulation and urination disorders were the least pronounced - in 4.4% and 2.9% of cases, respectively.
3. The presence of a positive association of the average closeness between the MDS–UPDRS-1 scale (nM-EDL) and the duration of the disease (r=0.5, p<0.05) was established. Thus, with the progression of PD, there was an increase in the severity of NMS.
Conclusion. The difficulties in diagnosing NMS in PD are due to the focus of neurologists' attention on the motor manifestations of PD. At the same time, NMS are an "invisible" part of the iceberg, requiring the primary attention of a doctor. The use of the MDS–UPDRS-1 (nM-EDL) scale by neurologists will contribute to the timely detection of NMS, appropriate therapeutic correction and dynamic monitoring of the severity of NMS.
Aigerim B. Utegenova1, https://orcid.org/0000-0001-5830-9703
Aigul P. Yermagambetova1, https://orcid.org/0000-0002-3230-0433
Gulnar B. Kabdrakhmanova1, https://orcid.org/0000-0001-6828-6437
Alima A. Khamidulla 1, https://orcid.org/0000-0002-5007-8151
Zhanilsin U. Urasheva1, https://orcid.org/0000-0003-0041-9218
1 West Kazakhstan Medical University named after Marat Ospanov, Department of neurology,
Aktobe city, Republic of Kazakhstan.
1. Aarsland D., Creese B., Politis M., Chaudhuri K.R., Ffytche D.H., Weintraub D., Ballard C. Cognitive decline in Parkinson disease // Nat Rev Neurol, 2017. 13(4), 217-231. https://doi.org/10.1038/nrneurol.2017.27
2. Adler C.H., Dugger B.N., Hentz J.G., Hinni M.L., Lott D.G., Driver-Dunckley E., Mehta S., Serrano G., Sue L. I., Duffy A., Intorcia A., Filon J., Pullen J., Walker D.G., Beach T.G. Peripheral Synucleinopathy in Early Parkinson's Disease: Submandibular Gland Needle Biopsy Findings // Movement Disorders, 2016. 31(2), 250-256. https://doi.org/10.1002/mds.26476
3. Al-Qassabi A., Tsao T.S., Racolta A., Kremer T., Cañamero M., Belousov A., et al. Immunohistochemical Detection of Synuclein Pathology in Skin in Idiopathic Rapid Eye Movement Sleep Behavior Disorder and Parkinsonism [Article]. // Movement Disorders. 2021, 36(4), 895-904. https://doi.org/10.1002/mds.28399
4. Alexoudi A., Alexoudi I., Gatzonis S. Parkinson's disease pathogenesis, evolution and alternative pathways: A review [Review] // Revue Neurologique174(10), 699-704. https://doi.org/10.1016/j.neurol.2017.12. 2018
5. Archibald N. K., Clarke M.P., Mosimann U.P., Burn D.J. Visual symptoms in Parkinson's disease and Parkinson's disease dementia // Mov Disord. 2011, 26(13), 2387-2395. https://doi.org/10.1002/mds.23891
6. Armstrong M.J. Advances in dementia with Lewy bodies Review // Therapeutic Advances in Neurological Disorders 2021. 14. https://doi.org/10.1177/17562864211057666
7. Asahina M., Vichayanrat E., Low D.A., Iodice V., Mathias C.J. Autonomic dysfunction in parkinsonian disorders: Assessment and pathophysiology // Journal of Neurology, Neurosurgery and Psychiatry. 2013, 84(6), 674-680. https://doi.org/10.1136/jnnp-2012-303135
8. Barone P., Erro R., Picillo M. Quality of Life and Nonmotor Symptoms in Parkinson's Disease // Int Rev Neurobiol. 2017. 133, 499-516. https://doi.org/10.1016/bs.irn.2017.05.023
9. Booth H.D.E., Wessely F., Connor-Robson N., Rinaldi F., Vowles J., Browne C., Evetts S. G., Hu M. T., Cowley S.A., Webber C., Wade-Martins R. RNA sequencing reveals MMP2 and TGFB1 downregulation in LRRK2 G2019S Parkinson's iPSC-derived astrocytes // Neurobiology of Disease. 2019, 129, 56-66. https://doi.org/10.1016/j.nbd.2019.05.006
10. Carelli V., Musumeci O., Caporali L., Zanna C., La Morgia C., Del Dotto V., Porcelli A.M. et al. Syndromic parkinsonism and dementia associated with OPA1 missense mutations // Annals of Neurology. 2015, 78(1), 21-38. https://doi.org/10.1002/ana.24410
11. Chang A., Fox S.H. Psychosis in Parkinson's Disease: Epidemiology, Pathophysiology, and Management // Drugs. 2016. 76(11), 1093-1118. https://doi.org/10.1007/s40265-016-0600-5
12. Chompoopong P., Reiter-Campeau S. Recent updates in autonomic research: orthostatic hypotension and cognitive function in Parkinson disease and multiple system atrophy, the skin as a window into synuclein pathology, and RFC1 repeat expansions in hereditary sensory autonomic neuropathies // Clinical Autonomic Research 2023. 33(4), 387-389. https://doi.org/10.1007/s10286-023-00968-4
13. Csóka M., Molnár S., Kellos É., Domján G. Problem solving care models of Parkinson's disease introduction: Parkinson's disease // Orvosi Hetilap, 2016., 157(22), 855-868. https://doi.org/10.1556/650.2016.30479
14. Donadio V., Incensi A., Rizzo G. et al. A new potential biomarker for dementia with Lewy bodies: Skin nerve alpha-synuclein deposits // Neurology. 2017, 89(4), 318-326. https://doi.org/10.1212/WNL.0000000000004146
15. Donaghy P.C., McKeith I.G. The clinical characteristics of dementia with Lewy bodies and a consideration of prodromal diagnosis // Alzheimer's Research and Therapy. 2014, 6(4), Article 46. https://doi.org/10.1186/alzrt274
16. Goetz C.G., Tilley B.C., Shaftman S.R., Stebbins G. T., Fahn S., Martinez-Martin P. et al. Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS): scale presentation and clinimetric testing results // Mov Disord. 2008, 23(15), 2129-2170. https://doi.org/10.1002/mds.22340
17. Goldstein D.S., Low P.A. Clinical evaluation of the autonomic nervous system // Continuum Lifelong Learning in Neurology. 2007. 13(6), 33-49. https://doi.org/10.1212/01.CON.0000299965.28266.ec
18. Guo W., Xu B., Sun H., Ma J., et al. Case Report: Progressive Asymmetric Parkinsonism Secondary to CADASIL Without Dementia // Frontiers in Neurology. 2022. 12, 760164. https://doi.org/10.3389/fneur.2021.760164
19. Hirsch L., Jette N., Frolkis A., Steeves T., Pringsheim T. The Incidence of Parkinson's Disease: A Systematic Review and Meta-Analysis // Neuroepidemiology. 2016. 46(4), 292-300. https://doi.org/10.1159/000445751
20. Hoehn M.M., Yahr M.D. Parkinsonism: onset, progression and mortality // Neurology. 1967, 17(5), 427-442. https://doi.org/10.1212/wnl.17.5.427
21. Hughes A.J., Daniel S.E., Kilford L., Lees A.J. Accuracy of clinical diagnosis of idiopathic Parkinson's disease: a clinico-pathological study of 100 cases // J Neurol Neurosurg Psychiatry, 1992, 55(3), 181-184. https://doi.org/10.1136/jnnp.55.3.181
22. Ikemura M., Saito Y., Sengoku R., Sakiyama Y., Hatsuta H., Kanemaru K., Sawabe M. et al. Lewy body pathology involves cutaneous nerves // Journal of Neuropathology and Experimental Neurology. 2008, 67(10), 945-953. https://doi.org/10.1097/NEN.0b013e318186de48
23. Iodice V., Low D.A., Vichayanrat E., Mathias C.J. Cardiovascular autonomic dysfunction in MSA and Parkinson's disease: similarities and differences // J Neurol Sci. 2011, 310(1-2), 133-138. https://doi.org/10.1016/j.jns.2011.07.014
24. Jagadeesan A. J., Murugesan R., Vimala Devi S., Meera M., Madhumala G., et al. Current trends in etiology, prognosis and therapeutic aspects of Parkinson's disease: a review // Acta Biomed. 2017. 88(3), 249-262. https://doi.org/10.23750/abm.v88i3.6063
25. Jain S. Multi-organ autonomic dysfunction in Parkinson disease // Parkinsonism and Related Disorders, 2011. 17(2), 77-83. https://doi.org/10.1016/j.parkreldis.2010.08.022
26. Kass-Iliyya L., Javed S., Gosal D., Kobylecki C., Marshall A., Petropoulos I.N. et al. Small fiber neuropathy in Parkinson's disease: A clinical, pathological and corneal confocal microscopy study // Parkinsonism and Related Disorders. 2015. 21(12), 1454-1460. https://doi.org/10.1016/j.parkreldis.2015.10.019
27. Khoo T.K., Yarnall A.J., Duncan G.W., Coleman S., O'Brien J.T., Brooks D.J., Barker R.A., Burn D.J. The spectrum of nonmotor symptoms in early Parkinson disease. // Neurology. 2013, 80(3), 276-281. https://doi.org/10.1212/WNL.0b013e31827deb74
28. Krishnan S., Sarma G., Sarma S., Kishore A. Do nonmotor symptoms in Parkinson's disease differ from normal aging? // Mov Disord. 2011, 26(11), 2110-2113. https://doi.org/10.1002/mds.23826
29. Maillet A., Krack P., Lhommée E., Météreau E., Klinger H., Favre E., Le Bars D., Schmitt E. et al. The prominent role of serotonergic degeneration in apathy, anxiety and depression in de novo Parkinson's disease // Brain. 2016. 139(Pt 9), 2486-2502. https://doi.org/10.1093/brain/aww162
30. Nègre-Pagès L., Regragui W., Bouhassira D., Grandjean H., Rascol O. Chronic pain in Parkinson's disease: the cross-sectional French DoPaMiP survey // Mov Disord (2008), 23(10), 1361-1369. https://doi.org/10.1002/mds.22142
31. Orimo S., Suzuki M., Inaba A., Mizusawa H. 123I-MIBG myocardial scintigraphy for differentiating Parkinson's disease from other neurodegenerative parkinsonism: a systematic review and meta-analysis // Parkinsonism Relat Disord. 2012., 18(5), 494-500. https://doi.org/10.1016/j.parkreldis.2012.01.009
32. Postuma R.B., Berg D., Stern M., Poewe W., Olanow C.W., Oertel W., Obeso J. et al. MDS clinical diagnostic criteria for Parkinson's disease // Mov Disord 2015, 30(12), 1591-1601. https://doi.org/10.1002/mds.26424
33. Saito Y., Shioya A., Sano T., Sumikura H., Murata M., Murayama SLewy body pathology involves the olfactory cells in Parkinson's disease and related disorders // Mov Disord, 2016. 31(1), 135-138. https://doi.org/10.1002/mds.26463
34. Sakakibara R., Kishi M., Ogawa E., Tateno F., Uchiyama T., Yamamoto T., Yamanishi T. Bladder, bowel, and sexual dysfunction in Parkinson's disease // Parkinsons Dis. 2011. 924605. https://doi.org/10.4061/2011/924605
35. Sveinbjornsdottir SThe clinical symptoms of Parkinson's disease // J Neurochem. 2016, 139 Suppl 1, 318-324. https://doi.org/10.1111/jnc.13691
36. Witjas T., Kaphan E., Azulay J. P., Blin O., Ceccaldi M., Pouget J., Poncet M., Chérif A. A. Nonmotor fluctuations in Parkinson's disease: frequent and disabling // Neurology, 2002, 59(3), 408-413. https://doi.org/10.1212/wnl.59.3.408
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Utegenova A.B., Yermagambetova A.P., Kabdrakhmanova G.B., Khamidulla A.A., Urasheva Zh.U. Non-Motor Symptoms in Parkinson's Disease using the example of Aktobe patients // Nauka i Zdravookhranenie [Science & Healthcare]. 2024, (Vol.26) 1, pp. 38-45. doi 10.34689/SH.2024.26.1.005Related publications:
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