The Impact of Prodromal Stage Non-Motor Symptoms on Clinical Progression in Parkinson’s Disease

Bahar Say

doi:10.4274/atfm.galenos.2021.56578

Research Article

Parkinson Hastalığında Prodromal Dönem Non-Motor Semptomların Hastalık Klinik Progresyonu Üzerine Etkisi

Year 2022, Volume: 75 Issue: 1, 63 - 68, 30.06.2022

Bahar Say

Abstract

Objectives: Several non-motor symptoms (NMSs) were described in the prodromal Parkinson’s disease (PD). The aim of this study is to investigate
the impact of the presence of prodromal NMSs on clinical progression of PD.

Materials and Methods: We questioned the presence of NMSs in the prediagnostic stage in patients with PD. Group 1 reported at least one
prodromal NMS and Group 2 reported no prodromal NMSs. As recommended by the Movement Disorder Society Task Force, the total likelihood
ratios (LRs) of NMSs were calculated and correlated with disease progression. Clinical progression was determined by dividing the Unified Parkinson’s
Disease Rating Scale Part III total score by the duration of the disease. Generalized linear model (GzLM) was used to determine associations between
clinical progression rate and the predictor variables.

Results: Group 1 had 48 patients (24 male, 24 female), and Group 2 had 46 patients (32 male, 14 female). Both groups were similar in terms of
demographic and disease characteristics. Depression and constipation (for each symptom, 18 patients and 37.5%) were common in Group 1. The
rate of clinical progression was higher in Group 1 than in Group 2 (p=0.037). There was no significant correlation between clinical progression rate
and LRs of NMSs in Group 1 (rs=0.10, p=0.49). However, age of the diagnosis was the only significant factor associated with the clinical progression
(p=0.69).

Conclusion: Prodromal NMSs do not seem to impact the rate of disease progression, which may be explained by the non-dopaminergic and extra
nigro-striatal pathway that cause NMSs.

Keywords

Parkinson’s Disease, Prodromal Stage, Constipation, Depression

Ethical Statement

Ethics Ethics Committee Approval: The study was approved by the Ankara University Ethics Committee (03-160-18/2018). Informed Consent: All participants provided a written informed consent.

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