The impact of non‐motor symptoms on health‐related quality of life of patients with Parkinson's disease

Martinez‐Martín, Pablo; Rodríguez‐Blázquez, Carmen; Kurtis, Mónica; Chaudhuri, K. Ray

doi:10.1002/mds.23462

Cited by 819 publications

(660 citation statements)

References 40 publications

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“…In a sample with a mean age of 64·0 years and 8·5 years of disease duration, the frequency of apathy was 17% (21 of 122), also lower than expected compared with the frequency of apathetic symptoms in similar samples that used less restrictive scales, such as the Neuropsychiatric Inventory and the Non-Motor Symptoms Scale. 43,46,129 Although previous diagnostic criteria 127,128 cover the most important subdimensions of apathy, the abstract nature of the items included might restrict their application in daily clinical practice. An additional limitation is the lack of items that relate apathetic symptoms to their possible cause: reward defi ciency syndrome, depression or emotional distress, or cognitive impairment.…”

Section: Review Diagnosis Of Apathy In Parkinson's Diseasementioning

confidence: 99%

Apathy in Parkinson's disease: clinical features, neural substrates, diagnosis, and treatment

Pagonabarraga

Kulisevsky

Strafella

et al. 2015

The Lancet Neurology

431

394

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Normal maintenance of human motivation depends on the integrity of subcortical structures that link the prefrontal cortex with the limbic system. Structural and functional disruption of diff erent networks within these circuits alters the maintenance of spontaneous mental activity and the capacity of aff ected individuals to associate emotions with complex stimuli. The clinical manifestations of these changes include a continuum of abnormalities in goal-oriented behaviours known as apathy. Apathy is highly prevalent in Parkinson's disease (and across many neurodegenerative disorders) and can severely aff ect the quality of life of both patients and caregivers. Diff erentiation of apathy from depression, and discrimination of its cognitive, emotional, and auto-activation components could guide an individualised approach to the treatment of symptoms. The opportunity to manipulate dopaminergic treatment in Parkinson's disease allows researchers to study a continuous range of motivational states, from apathy to impulse control disorders. Parkinson's disease can thus be viewed as a model that provides insight into the neural substrates of apathy.

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Section: Review Diagnosis Of Apathy In Parkinson's Diseasementioning

confidence: 99%

Apathy in Parkinson's disease: clinical features, neural substrates, diagnosis, and treatment

Pagonabarraga

Kulisevsky

Strafella

et al. 2015

The Lancet Neurology

431

394

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“…If isradipine only resulted in a difference in the rate of motor complications, this would represent a clinically meaningful outcome that would likely influence care. Nonmotor symptoms can be challenging to treat and have a disproportionate impact on quality of life 51, 52, 53. Therefore, therapy that influences these outcomes will likely have a significant impact on PD quality of life.…”

Section: Discussionmentioning

confidence: 99%

A novel design of a Phase III trial of isradipine in early Parkinson disease (STEADY‐PD III)

Biglan

Oakes

Lang

et al. 2017

Ann Clin Transl Neurol

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ObjectiveTo describe the rationale for a novel study design and baseline characteristics of a disease‐modifying trial of isradipine 10 mg daily in early Parkinson disease (PD).Methods STEADY‐PDIII is a 36‐month, Phase 3, parallel group, placebo‐controlled study of the efficacy of isradipine 10 mg daily in 336 participants with early PD as measured by the change in the Unified Parkinson Disease Rating Scale (UPDRS) Part I‐III score in the practically defined ON state. Secondary outcome measures include clinically meaningful measures of disability progression in early PD: (1) Time to initiation and utilization of dopaminergic therapy; (2) Time to onset of motor complications; (3) Change in nonmotor disability. Exploratory measures include global measures of functional disability, quality of life, change in the ambulatory capacity, cognitive function, and pharmacokinetic analysis. Rationale for the current design and alternative design approaches are discussed.ResultsThe entire cohort of 336 participants was enrolled at 55 Parkinson Study Group sites in North America. The percentage of male participants were 68.5% with a mean age of 61.9 years (sd 9.0), mean Hoehn and Yahr stage of 1.7 (sd 0.5), mean UPDRS total of 23.1 (sd 8.6), and MoCA of 28.1 (sd 1.4).Interpretation STEADY‐PD III has a novel and innovative design allowing for the determination of longer duration benefits on clinically relevant outcomes in a relatively small cohort on top of the benefit derived from symptomatic therapy. Baseline characteristics are similar to those in previously enrolled de novo PD trials. This study represents a unique opportunity to evaluate the potential impact of a novel therapy to slow progression of PD disability and provide clinically meaningful benefits.

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“…The burden of non-motor symptoms can define a patient's health-related quality of life [61], and is a major contributor to increased healthcare costs [62]. However, clinicians often regard the management of NMS as being secondary to motor symptom control.…”

Section: Management Of Non-motor Complicationsmentioning

confidence: 99%

Unmet needs in Parkinson's disease: New horizons in a changing landscape

Bhidayasiri

Laar

2016

Parkinsonism & Related Disorders

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a b s t r a c tThe success of levodopa and other classes of drugs have meant that most people with Parkinson's disease enjoy a good quality of life for many years. However, despite the availability of several drugs and formulations that can be used as monotherapy and in combination, there are a number of disease features that the current therapies are unable to address. The disease continues to progress despite treatment, patients suffer from a myriad of motor and non-motor symptoms, and a neuroprotective therapy is urgently required. To move forward with medical and surgical management, it is important to consider new insights that recent research offers and in this review we examine how a better understanding of the disease pathology and progression might improve and enrich our daily clinical practice. It is also timely to consider the service provision changes that will increasingly be needed to effectively manage the needs of the aging population.

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The impact of non‐motor symptoms on health‐related quality of life of patients with Parkinson's disease

Cited by 819 publications

References 40 publications

Apathy in Parkinson's disease: clinical features, neural substrates, diagnosis, and treatment

Apathy in Parkinson's disease: clinical features, neural substrates, diagnosis, and treatment

A novel design of a Phase III trial of isradipine in early Parkinson disease (STEADY‐PD III)

Unmet needs in Parkinson's disease: New horizons in a changing landscape

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