Severe Nonmotor Symptoms Found in Many Early Parkinson's Patients

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While motor symptom impairment is synonymous with Parkinson’s disease, nearly all patients in the early stages of the disorder also show non-motor symptoms (NMSs), including, fatigue, difficulty with memories, and sudden urgency to urinate.

In addition, the burden of the NMSs was considered either severe or very severe in more than one-third of patients in a recent trial that enrolled 234 patients with early Parkinson’s who were either on medication or were drug-naïve. Researchers said their findings have significant implications since while NMSs are known to be prevalent in Parkinson’s, many clinicians tend to downplay the seriousness of them.

Kallol Ray Chaudhuri, MD, of the National Parkinson Foundation International Centre of Excellence, King's College Hospital in London, United Kingdom, and colleagues followed 170 treated patients with early Parkinson’s (less than five years from diagnosis) and 64 drug-naïve patients.

In the treated patient group, the burden of NMS was mild in 29.4%, moderate in 34.1%, severe in 21.2% and considered very severe in 15.3%. In the drug-naïve group, the figures were, respectively, 28.1%, 29.7%, 21.9% and 18.8%.

The most common NMSs were fatigue, reported by, 57.6% and 57.8% of each group, respectively (treated and drug-naïve), memory difficulties, 51.2% and 48.4%, and urinary urgency by 57.1% and 46.9%.

Also, 57.8% of the drug-naïve group reported sadness and had poor mood or apathy, yet self-anxiety and depression was found to be worse in treated patients. The researchers suggested the latter may be because treated patients have a negative outlook on their condition.

“The NMS burden appears considerable compared to the motor burden at this stage suggesting that these observations have clinical implications and should pave the way to studies for non-motor subtyping within” Parkinson’s, the researchers concluded.

man with hand on head
Nonmotor symptoms, such as fatigue, can be severe in many early Parkinson's patients.

Almost all patients with early Parkinson's disease (PD) have nonmotor symptoms (NMSs), with more than a third having a severe burden of symptoms, a study shows.

Among the 170 patients with treated early PD (≤5 years from diagnosis), the burden of NMSs was mild in 29.4%, moderate in 34.1%, severe in 21.2% and very severe in 15.3%. The corresponding rates among 64 drug-naïve patients were 28.1%, 29.7%, 21.9% and 18.8%, while 1.6% had no NMSs.

Some of the most common NMSs were fatigue, reported by 57.6% and 57.8% of each group, respectively, while memory difficulties were reported by 51.2% and 48.4%, and urinary urgency by 57.1% and 46.9%.

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