Journal of Multidisciplinary Healthcare (Oct 2018)
Distribution of non-motor symptoms in idiopathic Parkinson’s disease and secondary Parkinsonism
Abstract
Orjan Skogar,1,2 Mats Nilsson1,3 1FUTURUM, Academy for Health and Care, Region Jönköping County, Jönköping, Sweden; 2Institution of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden; 3Department of Medical and Health Sciences, Linköping University, Linköping, Sweden Background: Non-motor symptoms (NMS) are frequent in patients with idiopathic Parkinson’s disease (IPD). Clinical expressions, postulated pathophysiological mechanisms, and responsiveness to antiparkinson medication represent differences between IPD and secondary Parkinsonism (SP).Objective: To evaluate NMS expressions in IPD, SP, and a matched control group.Methods: The accepted criteria for IPD and SP were controlled for the participants who were consecutively recruited at two outdoor patient clinics. The Well-Being Map™ was used as the evaluation instrument. These were completed by the participants before their visit. The controls consisted of non-Parkinsonian individuals who were matched by age and gender.Results: A total of 185 participants participated in the study, IPD/SP/controls; n=73/53 and 59, respectively. The mean age was 74 years, and the median duration of disease was 6/3 years. Differences were shown between the combined IPD/SP groups and the controls. Limited differences between the IPD and SP groups could be demonstrated. Symptoms such as pain, decreased taste, as well as sleep and bladder disturbances were more frequent in the IPD group. When more than minor problems with moving were reported, disturbances in sleep and digestion were also noted to a large extent.Conclusion: Despite differences in the pathophysiological mechanisms between IPD and SP, the study showed only minor differences in the expression of NMS. IPD and SP reported statistically more significant problems in all items compared to the controls. Sleeping problems were strongly associated with symptoms from the gastrointestinal tract, but sleep was only affected by longer disease duration to a minor extent. Motor symptoms, such as morning stiffness, were common in all three groups. Neurodegenerative diseases might have more complex expressions in common than what we have known before and it is certainly not a part of normal aging. Keywords: idiopathic Parkinson’s disease, motor symptoms, non-motor symptoms, secondary Parkinsonism, well-being map, Health related Quality of Life
