Prevalence of Non-motor Features Across the Various Stages of Idiopathic Parkinson’s Disease and its Correlation with the Severity and Duration of the Disease.

Shobana, N (2010) Prevalence of Non-motor Features Across the Various Stages of Idiopathic Parkinson’s Disease and its Correlation with the Severity and Duration of the Disease. Masters thesis, Madras Medical College, Chennai.

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Abstract

Non motor symptoms(NMS) in Parkinson’s Disease constitutes a major clinical challenge, as they are common, yet often overshadowed by the dominance of motor symptoms and high awareness of these among treating health care professionals. The NMS of PD were recognised by James Parkinson himself. Thus in his essay on the shaking Palsy in 1817, he referred to sleep disturbances, dysathria, constipation, dysphagia, sialorhoea, urinary incontinence, constant sleepiness with slight delirium. Since then numerous studies have indicated that NMS are frequent accompaniments of PD affecting memory, bladder and bowel and sleep among others. These NMS significantly affect the quality of life and may precipitate hospitalization. Although common the NMS of PD are not well recognised in clinical practice. While some such as depression, dementia, autonomic and sleep disturbances are well known, others such as dysphagia, dribbling of saliva, weight changes, sexual problems and diplopia are less well recognised. The NMS include neuropsychiatric symptoms, sleep disorders, autonomic symptoms, sensory symptoms and miscellaneous symptoms like diplopia, fatigue and seborhea. The nonmotor symptoms questionnaire (NMS Quest) and the nonmotor symprom scale (NMSS) were developed to assess the frequency and severity of NMS in PD patients across all stages. The NMS Quest was validated in March 2007 by the Movement Disorder Society. It covers 9 domains and includes 30 items, including sleep / fatigue, cardiovascular, mood/cognition, perceptual problems, attention / memory, gastrointestinal, urinary, sexual functions and miscellaneous. The NMS Quest does not provide an overall score or disability and is not a graded rating instrument. It is a screening tool designed to draw attention to the presence of NMS and to initiate further investigation. Nonmotor symptoms are prevalent across all stages of Parkinson’s Disease. (2) The most prevalent ones were Autonomic which includes Constipation, Nocturia, Urgency and sweating. This was followed by insomnia, depression and memory disturbances. Dizziness, Drooling, Falls and unexplained pains were also significantly reported. (3) The number of NMS increased as the disease severity progressed. The number of NMS in stages 1 and 1.5 were the least. It increased through stages 2 and 2.5 and were highest reported in stages 3 and 4. (4) The number of NMS also correlated with the duration of the disease. The number of NMS were least when the duration was less than 2 years, increasing as the duration increased and maximum reported when duration was more than 5 years.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Prevalence of Non-motor ; Idiopathic Parkinson’s Disease ; Correlation ; Severity.
Subjects: MEDICAL > Neurology
Depositing User: Kambaraman B
Date Deposited: 28 Jun 2017 11:43
Last Modified: 28 Jun 2017 11:43
URI: http://repository-tnmgrmu.ac.in/id/eprint/577

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