Kurlawala Zimple, Shadowen Paul H, McMillan Joseph D, Beverly Levi J, Friedland Robert P
Diabetes and Obesity Center, University of Louisville, Louisville, KY 40292, USA.
School of Medicine, University of Louisville, Louisville, KY 40292, USA.
Parkinsons Dis. 2021 Apr 1;2021:8898887. doi: 10.1155/2021/8898887. eCollection 2021.
Nonmotor symptoms (NMS) in Parkinson's disease (PD) can start up to a decade before motor manifestations and strongly correlate with the quality of life. Understanding patterns of NMS can provide clues to the incipient site of PD pathology. Our goal was to systematically characterize the progression of NMS in PD ( = 489), compared to healthy controls, HC ( = 241), based on the sex of the subjects and laterality of motor symptom onset. Additionally, NMS experienced at the onset of PD were also compared to subjects with scans without dopaminergic deficit, SWEDD ( = 81). The Parkinson's Progression Markers Initiative (PPMI) database was utilized to analyze several NMS scales. NMS experienced by PD and SWEDD cohorts were significantly higher than HC and both sex and laterality influenced several NMS scales at the onset of motor symptoms. . PD males experienced significant worsening of sexual, urinary, sleep, and cognitive functions compared to PD females. PD females reported significantly increased thermoregulatory dysfunction and anxious mood over 7 years and significantly more constipation during the first 4 years after PD onset. . At onset, PD subjects with right-sided motor predominance reported significantly higher autonomic dysfunction. Subjects with left-sided motor predominance experienced significantly more anxious mood at onset which continued as Parkinson's progressed. In conclusion, males experienced increased NMS burden in Parkinson's disease. Laterality of motor symptoms did not significantly influence NMS progression, except anxious mood. We analyzed NMS in a large cohort of PD patients, and these data are valuable to improve PD patients' quality of life by therapeutically alleviating nonmotor symptoms.
帕金森病（PD）的非运动症状（NMS）可在运动症状出现前长达十年就开始出现，且与生活质量密切相关。了解NMS的模式可为PD病理的起始部位提供线索。我们的目标是，基于受试者的性别和运动症状发作的侧别，系统地描述PD患者（n = 489）与健康对照（HC，n = 241）相比NMS的进展情况。此外，还将PD发作时出现的NMS与无多巴胺能缺陷扫描的受试者（SWEDD，n = 81）进行了比较。利用帕金森病进展标志物倡议（PPMI）数据库分析了多个NMS量表。PD和SWEDD队列经历的NMS显著高于HC，并且性别和侧别在运动症状发作时均影响多个NMS量表。与PD女性相比，PD男性在性、泌尿、睡眠和认知功能方面有明显恶化。PD女性报告称，在7年期间体温调节功能障碍和焦虑情绪显著增加，在PD发病后的前4年便秘明显更多。在发病时，右侧运动占优势的PD受试者报告的自主神经功能障碍明显更高。左侧运动占优势的受试者在发病时焦虑情绪明显更多，且随着帕金森病的进展持续存在。总之，男性在帕金森病中NMS负担增加。除焦虑情绪外，运动症状的侧别对NMS进展没有显著影响。我们在一大群PD患者中分析了NMS，这些数据对于通过治疗性缓解非运动症状来改善PD患者的生活质量很有价值。
