The progression of non-motor symptoms in Parkinson's disease and their contribution to motor disability and quality of life

Angelo Antonini; Paolo Barone; R Marconi; Letterio Morgante; S Zappulla; Fe Pontieri; Silvia Ramat; Mg Ceravolo; Giuseppe Meco; G Cicarelli; M Pederzoli; Michela Manfredi; R Ceravolo; M Mucchiut; Giampiero Volpe; Giovanni Abbruzzese; E Bottacchi; Luigi Bartolomei; G Ciacci; A Cannas; Mg Randisi; Alfredo Petrone; M Baratti; V Toni; G Cossu; P Del Dotto; Anna Rita Bentivoglio; M Abrignani; R Scala; F Pennisi; Rocco Quatrale; Rm Gaglio; Alessandra Nicoletti; M Perini; T Avarello; A Pisani; A Scaglioni; Pe Martinelli; F Iemolo; L Ferigo; P Simone; Paola Soliveri; B Troianiello; D Consoli; A Mauro; L Lopiano; G Nastasi; C. Colosimo

doi:10.1007/s00415-012-6557-8

The progression of non-motor symptoms in Parkinson's disease and their contribution to motor disability and quality of life

Angelo Antonini, Paolo Barone, R Marconi, Letterio Morgante, S Zappulla, Fe Pontieri, Silvia Ramat, Mg Ceravolo, Giuseppe Meco, G Cicarelli, M Pederzoli, Michela Manfredi, R Ceravolo, M Mucchiut, Giampiero Volpe, Giovanni Abbruzzese, E Bottacchi, Luigi Bartolomei, G Ciacci, A CannasMg Randisi, Alfredo Petrone, M Baratti, V Toni, G Cossu, P Del Dotto, Anna Rita Bentivoglio, M Abrignani, R Scala, F Pennisi, Rocco Quatrale, Rm Gaglio, Alessandra Nicoletti, M Perini, T Avarello, A Pisani, A Scaglioni, Pe Martinelli, F Iemolo, L Ferigo, P Simone, Paola Soliveri, B Troianiello, D Consoli, A Mauro, L Lopiano, G Nastasi, C. Colosimo

Risultato della ricerca: Contributo in rivista › Articolo in rivista

134 Citazioni (Scopus)

Abstract

Non-motor symptoms are gaining relevance in Parkinson's disease (PD) management but little is known about their progression and contribution to deterioration of quality of life. We followed prospectively 707 PD patients (62 % males) for 2 years. We assessed non-motor symptoms referred to 12 different domains, each including 1-10 specific symptoms, as well as motor state (UPDRS), general cognition, and life quality. Hoehn & Yahr (H&Y) stage was used to categorize patient status (I-II mild; III moderate; IV-V severe). We found that individual non-motor symptoms had variable evolution over the 2-year follow-up with sleep, gastrointestinal, attention/memory and skin disturbances (hyperhidrosis and seborrhea) becoming more prevalent and psychiatric, cardiovascular, and respiratory disorders becoming less prevalent. Development of symptoms in the cardiovascular, apathy, urinary, psychiatric, and fatigue domains was associated with significant life-quality worsening (p < 0.0045, alpha with Bonferroni correction). During the observation period, 123 patients (17 %) worsened clinically while 584 were rated as stable. There was a fivefold greater increase in UPDRS motor score in worse compared with stable patients over 24 months (p < 0.0001 vs. baseline both in stable and worse group). The total number of reported non-motor symptoms increased over 24 months in patients with motor worsening compared to stable ones (p < 0.001). Thirty-nine patients died (3.4 % of patients evaluable at baseline) with mean age at death of 74 years. Deceased patients were older, had significantly higher H&Y stage and motor score, and reported a greater number of non-motor symptoms at baseline. In conclusion, overall non-motor symptom progression does not follow motor deterioration, is symptom-specific, and only development of specific domains negatively impacts quality of life. These results have consequences for drug studies targeting non-motor features.

Lingua originale	English
pagine (da-a)	N/A-N/A
Rivista	Journal of Neurology
DOI	https://doi.org/10.1007/s00415-012-6557-8
Stato di pubblicazione	Pubblicato - 2012

Keywords

Cognition
Mortality
Non-motor symptoms
Parkinson’s disease

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10.1007/s00415-012-6557-8

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Antonini, A., Barone, P., Marconi, R., Morgante, L., Zappulla, S., Pontieri, F., Ramat, S., Ceravolo, M., Meco, G., Cicarelli, G., Pederzoli, M., Manfredi, M., Ceravolo, R., Mucchiut, M., Volpe, G., Abbruzzese, G., Bottacchi, E., Bartolomei, L., Ciacci, G., ... Colosimo, C. (2012). The progression of non-motor symptoms in Parkinson's disease and their contribution to motor disability and quality of life. Journal of Neurology, N/A-N/A. https://doi.org/10.1007/s00415-012-6557-8

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abstract = "Non-motor symptoms are gaining relevance in Parkinson's disease (PD) management but little is known about their progression and contribution to deterioration of quality of life. We followed prospectively 707 PD patients (62 % males) for 2 years. We assessed non-motor symptoms referred to 12 different domains, each including 1-10 specific symptoms, as well as motor state (UPDRS), general cognition, and life quality. Hoehn & Yahr (H&Y) stage was used to categorize patient status (I-II mild; III moderate; IV-V severe). We found that individual non-motor symptoms had variable evolution over the 2-year follow-up with sleep, gastrointestinal, attention/memory and skin disturbances (hyperhidrosis and seborrhea) becoming more prevalent and psychiatric, cardiovascular, and respiratory disorders becoming less prevalent. Development of symptoms in the cardiovascular, apathy, urinary, psychiatric, and fatigue domains was associated with significant life-quality worsening (p < 0.0045, alpha with Bonferroni correction). During the observation period, 123 patients (17 %) worsened clinically while 584 were rated as stable. There was a fivefold greater increase in UPDRS motor score in worse compared with stable patients over 24 months (p < 0.0001 vs. baseline both in stable and worse group). The total number of reported non-motor symptoms increased over 24 months in patients with motor worsening compared to stable ones (p < 0.001). Thirty-nine patients died (3.4 % of patients evaluable at baseline) with mean age at death of 74 years. Deceased patients were older, had significantly higher H&Y stage and motor score, and reported a greater number of non-motor symptoms at baseline. In conclusion, overall non-motor symptom progression does not follow motor deterioration, is symptom-specific, and only development of specific domains negatively impacts quality of life. These results have consequences for drug studies targeting non-motor features.",

keywords = "Cognition, Mortality, Non-motor symptoms, Parkinson{\textquoteright}s disease, Cognition, Mortality, Non-motor symptoms, Parkinson{\textquoteright}s disease",

author = "Angelo Antonini and Paolo Barone and R Marconi and Letterio Morgante and S Zappulla and Fe Pontieri and Silvia Ramat and Mg Ceravolo and Giuseppe Meco and G Cicarelli and M Pederzoli and Michela Manfredi and R Ceravolo and M Mucchiut and Giampiero Volpe and Giovanni Abbruzzese and E Bottacchi and Luigi Bartolomei and G Ciacci and A Cannas and Mg Randisi and Alfredo Petrone and M Baratti and V Toni and G Cossu and {Del Dotto}, P and Bentivoglio, {Anna Rita} and M Abrignani and R Scala and F Pennisi and Rocco Quatrale and Rm Gaglio and Alessandra Nicoletti and M Perini and T Avarello and A Pisani and A Scaglioni and Pe Martinelli and F Iemolo and L Ferigo and P Simone and Paola Soliveri and B Troianiello and D Consoli and A Mauro and L Lopiano and G Nastasi and C. Colosimo",

year = "2012",

doi = "10.1007/s00415-012-6557-8",

language = "English",

pages = "N/A--N/A",

journal = "Journal of Neurology",

issn = "0340-5354",

publisher = "Springer Verlag Germany:Tiergartenstrasse 17, D 69121 Heidelberg Germany:011 49 6221 3450, EMAIL: g.braun@springer.de, INTERNET: http://www.springer.de, Fax: 011 49 6221 345229",

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Antonini, A, Barone, P, Marconi, R, Morgante, L, Zappulla, S, Pontieri, F, Ramat, S, Ceravolo, M, Meco, G, Cicarelli, G, Pederzoli, M, Manfredi, M, Ceravolo, R, Mucchiut, M, Volpe, G, Abbruzzese, G, Bottacchi, E, Bartolomei, L, Ciacci, G, Cannas, A, Randisi, M, Petrone, A, Baratti, M, Toni, V, Cossu, G, Del Dotto, P, Bentivoglio, AR, Abrignani, M, Scala, R, Pennisi, F, Quatrale, R, Gaglio, R, Nicoletti, A, Perini, M, Avarello, T, Pisani, A, Scaglioni, A, Martinelli, P, Iemolo, F, Ferigo, L, Simone, P, Soliveri, P, Troianiello, B, Consoli, D, Mauro, A, Lopiano, L, Nastasi, G & Colosimo, C 2012, 'The progression of non-motor symptoms in Parkinson's disease and their contribution to motor disability and quality of life', Journal of Neurology, pagg. N/A-N/A. https://doi.org/10.1007/s00415-012-6557-8

TY - JOUR

T1 - The progression of non-motor symptoms in Parkinson's disease and their contribution to motor disability and quality of life

AU - Antonini, Angelo

AU - Barone, Paolo

AU - Marconi, R

AU - Morgante, Letterio

AU - Zappulla, S

AU - Pontieri, Fe

AU - Ramat, Silvia

AU - Ceravolo, Mg

AU - Meco, Giuseppe

AU - Cicarelli, G

AU - Pederzoli, M

AU - Manfredi, Michela

AU - Ceravolo, R

AU - Mucchiut, M

AU - Volpe, Giampiero

AU - Abbruzzese, Giovanni

AU - Bottacchi, E

AU - Bartolomei, Luigi

AU - Ciacci, G

AU - Cannas, A

AU - Randisi, Mg

AU - Petrone, Alfredo

AU - Baratti, M

AU - Toni, V

AU - Cossu, G

AU - Del Dotto, P

AU - Bentivoglio, Anna Rita

AU - Abrignani, M

AU - Scala, R

AU - Pennisi, F

AU - Quatrale, Rocco

AU - Gaglio, Rm

AU - Nicoletti, Alessandra

AU - Perini, M

AU - Avarello, T

AU - Pisani, A

AU - Scaglioni, A

AU - Martinelli, Pe

AU - Iemolo, F

AU - Ferigo, L

AU - Simone, P

AU - Soliveri, Paola

AU - Troianiello, B

AU - Consoli, D

AU - Mauro, A

AU - Lopiano, L

AU - Nastasi, G

AU - Colosimo, C.

PY - 2012

Y1 - 2012

N2 - Non-motor symptoms are gaining relevance in Parkinson's disease (PD) management but little is known about their progression and contribution to deterioration of quality of life. We followed prospectively 707 PD patients (62 % males) for 2 years. We assessed non-motor symptoms referred to 12 different domains, each including 1-10 specific symptoms, as well as motor state (UPDRS), general cognition, and life quality. Hoehn & Yahr (H&Y) stage was used to categorize patient status (I-II mild; III moderate; IV-V severe). We found that individual non-motor symptoms had variable evolution over the 2-year follow-up with sleep, gastrointestinal, attention/memory and skin disturbances (hyperhidrosis and seborrhea) becoming more prevalent and psychiatric, cardiovascular, and respiratory disorders becoming less prevalent. Development of symptoms in the cardiovascular, apathy, urinary, psychiatric, and fatigue domains was associated with significant life-quality worsening (p < 0.0045, alpha with Bonferroni correction). During the observation period, 123 patients (17 %) worsened clinically while 584 were rated as stable. There was a fivefold greater increase in UPDRS motor score in worse compared with stable patients over 24 months (p < 0.0001 vs. baseline both in stable and worse group). The total number of reported non-motor symptoms increased over 24 months in patients with motor worsening compared to stable ones (p < 0.001). Thirty-nine patients died (3.4 % of patients evaluable at baseline) with mean age at death of 74 years. Deceased patients were older, had significantly higher H&Y stage and motor score, and reported a greater number of non-motor symptoms at baseline. In conclusion, overall non-motor symptom progression does not follow motor deterioration, is symptom-specific, and only development of specific domains negatively impacts quality of life. These results have consequences for drug studies targeting non-motor features.

AB - Non-motor symptoms are gaining relevance in Parkinson's disease (PD) management but little is known about their progression and contribution to deterioration of quality of life. We followed prospectively 707 PD patients (62 % males) for 2 years. We assessed non-motor symptoms referred to 12 different domains, each including 1-10 specific symptoms, as well as motor state (UPDRS), general cognition, and life quality. Hoehn & Yahr (H&Y) stage was used to categorize patient status (I-II mild; III moderate; IV-V severe). We found that individual non-motor symptoms had variable evolution over the 2-year follow-up with sleep, gastrointestinal, attention/memory and skin disturbances (hyperhidrosis and seborrhea) becoming more prevalent and psychiatric, cardiovascular, and respiratory disorders becoming less prevalent. Development of symptoms in the cardiovascular, apathy, urinary, psychiatric, and fatigue domains was associated with significant life-quality worsening (p < 0.0045, alpha with Bonferroni correction). During the observation period, 123 patients (17 %) worsened clinically while 584 were rated as stable. There was a fivefold greater increase in UPDRS motor score in worse compared with stable patients over 24 months (p < 0.0001 vs. baseline both in stable and worse group). The total number of reported non-motor symptoms increased over 24 months in patients with motor worsening compared to stable ones (p < 0.001). Thirty-nine patients died (3.4 % of patients evaluable at baseline) with mean age at death of 74 years. Deceased patients were older, had significantly higher H&Y stage and motor score, and reported a greater number of non-motor symptoms at baseline. In conclusion, overall non-motor symptom progression does not follow motor deterioration, is symptom-specific, and only development of specific domains negatively impacts quality of life. These results have consequences for drug studies targeting non-motor features.

KW - Cognition

KW - Mortality

KW - Non-motor symptoms

KW - Parkinson’s disease

KW - Cognition

KW - Mortality

KW - Non-motor symptoms

KW - Parkinson’s disease

UR - http://hdl.handle.net/10807/27961

U2 - 10.1007/s00415-012-6557-8

DO - 10.1007/s00415-012-6557-8

M3 - Article

SN - 0340-5354

SP - N/A-N/A

JO - Journal of Neurology

JF - Journal of Neurology

ER -

The progression of non-motor symptoms in Parkinson's disease and their contribution to motor disability and quality of life

Abstract

Keywords

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