Prevalence of nonmotor symptoms in patients with Parkinson’s disease in Split-Dalmatia County

Abstract

Introduction: This study aimed to review the prevalence of NMS in patients with Parkinson's disease in Split-Dalmatia County and to investigate the effects of other variables on the number and structure of NMS. Materials and Methods: This observational cross-sectional pilot study was conducted at the Department of Neurology, University Hospital of Split. This study lasted from November 2017. to April 2018. and it included 31 patients, hospitalized or treated in the infirmary at the Department of Neurology. By examining medical documentation we acquired necessary demographic and medical information about our subjects. Subjects were then examined and subjected to filling out Parkinson's disease-specific questionnaires: NMSQuest, Hoehn&Yahr scale, UPDRS, and Schwab&England scale. To analyze given variables we used the Mann-Whitney U test, Kruskal-Wallis test, Spearman's coefficient of correlation, and ꭓ2 test. Results: On average 12 dwifferent NMS were reported per patient. Most prevalent NMS were reported to be nocturia (67.74%), urinary urgency (61.29%), constipation (61.29%), intense dreams (58.06%), and forgetfulness (58.06%). The least prevalent NMS reported were delusions (6.45%), hallucinations (16.12%), and daytime sleepiness (25.80%). There were neither statistical differences in the total number of NMS nor in demographic variables between men and women. The increased burden of NMS correlated with the disease duration. Prevalence of depression, anxiety, and miscellaneous symptoms rose with the length of disease duration. We established a connection between the number of NMS and the stage of disease according to Hoehn and Yahr. Patients in higher stages of disease (moderate and severe) reported more severe NMS burden than patients in the mild stage of the disease, while patients in the moderate stage had the largest NMS score of all groups. Patients in the mild stage reported urinary, also digestive, and cognitive symptoms, in the moderate stage urinary symptoms, sexual dysfunction, and cardiovascular symptoms were most reported, while in the severe stage of the disease, patients reported cardiovascular symptoms, depression, and anxiety alongside urinary symptoms as most prevalent. Conclusions: Patients are most affected by the autonomic spectrum of NMS, especially urinary symptoms. Duration of the disease and stage of the disease are proven to affect the total number of NMS, while age at onset, current age, and sex have been disproven to have any effect on the total NMS score. Patients in the moderate stage reported the most NMS.