Sánchez-Martínez Claudia Marisol, Choreño-Parra José Alberto, Placencia-Álvarez Noel, Nuñez-Orozco Lilia, Guadarrama-Ortiz Parménides
Department of Neurology, Centro Médico Nacional 20 de Noviembre, ISSSTE, Mexico City, Mexico.
Centro Especializado en Neurocirugía y Neurociencias México (CENNM), Mexico City, Mexico.
Front Neurol. 2019 Nov 14;10:1197. doi: 10.3389/fneur.2019.01197. eCollection 2019.
The clinical phenotype of Parkinson's disease (PD) encompasses a wide range of non-motor symptoms (NMS) compromising the quality of life of affected patients. Currently, information about NMS in PD is scarce among Hispanic populations. Furthermore, few studies have reported the temporal pattern of NMS presentation. We conducted a cross-sectional study aimed to describe the frequency and time of NMS occurrence in Hispanic patients with PD using the self-completed NMS questionnaire (NMSQuest). Participants were interrogated about the time of each NMS presentation respect to the onset of motor symptoms. The frequency of NMS was described according to gender, age at disease onset, disease duration and Hoehn and Yahr (H&Y) stage. We enrolled 120 patients, 73.33% males and 26.66% females, with a mean age of 63.33 ± 8.60 years. All the participants presented at least 1 NMS. The median number of NMS per patient was 12. The most frequent NMS domains were miscellaneous, urinary tract, sleep/fatigue, and gastrointestinal tract symptoms, with no significant gender differences. The most frequent individual NMS were nocturia, urinary urgency, feeling sadness, and constipation. Any patient reported NMS before the onset of motor manifestations. The pattern of occurrence of NMS domains in our population was as follows: attention/memory, cardiovascular, gastrointestinal tract, perceptual problems/hallucinations, mood/cognition, urinary, miscellaneous, sleep/fatigue, and sexual function. Nausea/vomiting was the earliest symptom observed in all patients, whereas sexual dysfunction and changes in interest for sex were the last symptoms to occur. We found no differences in the total number and frequency of NMS between participants grouped according to their age at disease onset. Conversely, patients with a duration of disease >10 years reported a higher frequency of NMS compared to participants with a duration of disease < 10 years. The total number of NMS per patient increased as the HY stage progressed. The proportion of patients presenting symptoms of the gastrointestinal tract, urinary tract, mood/cognition, cardiovascular, and sexual function domains was higher in the HY 4-5 group. Our study provides relevant data to improve our understanding of NMS in PD, which may contribute to anticipate and plan diagnostic and therapeutic strategies among Hispanic PD patients.
帕金森病（PD）的临床表型包括多种非运动症状（NMS），这些症状会影响患者的生活质量。目前，西班牙裔人群中关于帕金森病非运动症状的信息较少。此外，很少有研究报告非运动症状出现的时间模式。我们进行了一项横断面研究，旨在使用自我填写的非运动症状问卷（NMSQuest）描述西班牙裔帕金森病患者非运动症状出现的频率和时间。询问参与者每种非运动症状相对于运动症状发作的出现时间。根据性别、发病年龄、病程以及霍恩和雅尔（H&Y）分期描述非运动症状的频率。我们招募了120名患者，其中男性占73.33%，女性占26.66%，平均年龄为63.33±8.60岁。所有参与者至少出现1种非运动症状。每位患者非运动症状的中位数为12种。最常见的非运动症状领域是杂项、泌尿系统、睡眠/疲劳和胃肠道症状，无显著性别差异。最常见的个体非运动症状是夜尿症、尿急、悲伤情绪和便秘。任何患者在运动表现出现之前就报告了非运动症状。我们人群中非运动症状领域的出现模式如下：注意力/记忆力、心血管、胃肠道、感知问题/幻觉、情绪/认知、泌尿系统、杂项、睡眠/疲劳和性功能。恶心/呕吐是所有患者中最早出现的症状，而性功能障碍和性兴趣改变是最后出现的症状。我们发现，根据发病年龄分组的参与者之间，非运动症状的总数和频率没有差异。相反，病程>10年的患者报告的非运动症状频率高于病程<10年的参与者。随着H&Y分期进展，每位患者非运动症状的总数增加。在H&Y 4 - 5组中，出现胃肠道、泌尿系统、情绪/认知、心血管和性功能领域症状的患者比例更高。我们的研究提供了相关数据，以增进我们对帕金森病非运动症状的理解，这可能有助于在西班牙裔帕金森病患者中预测和规划诊断及治疗策略。
