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The Clinical Profile of Nonmotor Fluctuations in Parkinson's Disease Patients

Published online by Cambridge University Press:  02 December 2014

Dilek Ince Gunal ,
Kerim Nurichalichi ,
Nese Tuncer ,
Nural Bekiroglu  and
Sevinç Aktan
Dilek Ince Gunal
Affiliation:
Department of Neurology, Marmara University Hospital, Altunizade 81190, Istanbul, Turkey
Kerim Nurichalichi
Affiliation:
Department of Neurology, Marmara University Hospital, Altunizade 81190, Istanbul, Turkey
Nese Tuncer
Affiliation:
Department of Neurology, Marmara University Hospital, Altunizade 81190, Istanbul, Turkey
Nural Bekiroglu
Affiliation:
Department of Biostatistics, Marmara University Hospital, Altunizade 81190, Istanbul, Turkey
Sevinç Aktan
Affiliation:
Department of Neurology, Marmara University Hospital, Altunizade 81190, Istanbul, Turkey
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Abstract

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Objective:

Recently described nonmotor fluctuations may cause disability in Parkinson's disease patients. These fluctuations are generally grouped as sensory, autonomic and psychiatric. The clinical spectrum and frequency of these fluctuating symptoms are not well-described.

Methods:

We studied the relationship of nonmotor fluctuations with motor symptoms and determined the influence of age at disease onset, duration of disease, dosage and duration of levodopa treatment in the appearance of nonmotor fluctuations.

Results:

Statistical analysis showed a relationship of disease-related parameters with sensory and autonomic fluctuations but psychiatric fluctuations were only found to be associated with the duration of levodopa usage. The nonmotor fluctuations included in the study were observed during “on” periods as well as “off” periods.

Conclusion:

Nonmotor fluctuations had variable presentations. Moreover, their co-appearance with different types of motor fluctuations may be linked to the effect of other neurotransmitter systems acting synchronously with dopamine. Risk factors for sensory and autonomic fluctuations in patients with Parkinson's disease were early age of disease onset, longer duration and higher dose of levodopa use. Psychiatric fluctuations were only associated with higher doses of levodopa.

Résumé:

RÉSUMÉ:Objectif:

Les fluctuations non motrices décrites récemment peuvent être invalidantes chez les parkinsoniens. Ces fluctuations sont généralement sensitives, neurovégétatives ou psychiatriques. Le spectre clinique et la fréquence de ces symptômes fluctuants n'ont pas été décrits avec précision.

Méthodes:

Nous avons étudié la relation entre les fluctuations non motrices et les symptômes moteurs et nous avons déterminé l'influence de l'âge de début de la maladie, la durée de la maladie, le dosage et la durée du traitement par la lévodopa par rapport à l'apparition des fluctuations non motrices.

Résultats:

L'analyse statistique a montré une relation entre les paramètres reliés à la maladie et les fluctuations sensitives etneurovégétatives. Cependant les fluctuations psychiatriques n'ont été associées qu'à la durée de l'utilisation de la lévodopa. Les fluctuations non motrices incluses dans l'étude étaient observées tant pendant les périodes “on” que pendant les périodes “off”.

Conclusion:

La présentation des fluctuations non motrices était variable. De plus, leur présence associée à différents types de fluctuations motrices peut être en relation avec l'effet d'autre systèmes de neurotransmetteurs en synchronie avec la dopamine. Les facteurs de risque des fluctuations sensitives et neurovégétatives chez les parkinsoniens étaient un âge de début précoce ainsi qu'une posologie élevée de lévodopa et une durée de traitement plus longue. Les fluctuations psychiatriques n'étaient associées qu'avec une posologie plus élevée de lévodopa.

Type
Original Article
Information
Canadian Journal of Neurological Sciences , Volume 29 , Issue 1 , February 2002 , pp. 61 - 64
Copyright
Copyright © Canadian Neurological Sciences Federation 2002

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