Nonmotor symptoms of Parkinson's disease: Prevalence and awareness of patients and families
Introduction
The nonmotor symptoms of Parkinson's disease(PD) have been described since they were first reported by James Parkinson [1]. However, they have been largely neglected by both physicians and patients compared to the typical motor symptoms, which are the main symptoms corresponding to the criteria for the diagnosis [2]. In fact, PD patients report many nonmotor symptoms, such as cognitive dysfunctions, psychiatric disturbances, sleep disorders, dysautonomia, and sensory symptoms, which can be explained by wide pathological alterations beyond the substantia nigra in PD [3], [4]. These nonmotor symptoms can cause problems in the daily life of patients and have as great an impact on the quality of life as the motor symptoms [5], [6]. Recently there have been many researchers who advocate a comprehensive approach to nonmotor symptoms, and interest is increasing thanks to their efforts [7], [8].
Despite these efforts, the reason that nonmotor symptoms are not adequately treated must be because they are not as obvious as motor symptoms. One of the major reasons that nonmotor symptoms are not adequately managed is that patients and their families may not be aware of the connection of their nonmotor symptoms to their disease. If the patients or their family members are aware that such symptoms are caused by or related to PD, they will complain about these symptoms, and the doctor will try to manage the symptoms appropriately. This will also save unnecessary tests and treatments due to misdiagnosis.
On the assumption that interest in the nonmotor symptoms of PD may depend on the awareness of the patients and their families, this study attempted to determine how frequent nonmotor symptoms are and how aware the patients and their family members are of the relationship between nonmotor symptoms and PD.
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Subjects
We evaluated 74 consecutive patients who had been diagnosed with PD under the diagnostic criteria of Gelb et al. [9] and 54 family members. All patients had been treated with dopaminergic therapy. All patients and family members in this study provided written informed consent.
Methods
A survey of the nonmotor symptoms was carried out using a translated version of the patient questionnaire introduced in a recent study on NonMotor Symptoms Questionnaire (NMSQuest study) by qualified translators [10]. The
Prevalence of nonmotor symptoms
Seventy-four patients (28 males and 46 females, age 64.9±8.6 years) participated. H–Y stage of the patients ranged from 1.5 to 3, and their average duration of parkinsonian symptoms was 6.4±6.1 years (Table 1).
The most frequent nonmotor symptom was nocturia (67.6%). It was followed by restless legs, constipation, feeling sad, orthostatic dizziness, and memory disturbance, of which more than 60% of the patients complained. The least frequent nonmotor symptoms were bowel incontinence, delusions,
Discussion
This study used a self-reporting questionnaire for a comprehensive approach to nonmotor symptoms in order to determine how frequently nonmotor symptoms occur in PD patients and how aware they were of the relationship of these symptoms to PD. Chaudhuri et al. [10] selected 50 symptoms of PD based on their research of published studies, surveys of patients, nurses, and family members of the patients, and narrowed them down to 30 symptoms. According to them, to the question that asked whether the
Acknowledgement
This work was supported by Dong-A University Research Fund in 2004.
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