Tapdia Madhusudan, Kumar Anand, Yadav Ajay Kumar, Singh Varun Kumar, Pathak Abhishek, Chaurasia Rameshwar Nath, Mishra Vijaya Nath, Dubey Navneet Kumar, Dhiman Neetu Rani, Shailesh Monika, Joshi Deepika
Department of Neurology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India.
Department of Anatomy, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India.
Ann Neurosci. 2025 Apr 30:09727531251321234. doi: 10.1177/09727531251321234.
Non-motor symptoms (NMS) are frequently overlooked, yet they significantly contribute to the progression of Parkinson's disease (PD) or atypical parkinsonism (AP), which include multiple system atrophy (MSA), progressive supranuclear palsy (PSP). Moreover, discrepancies exist in non-motor symptom scale (NMSS) scores for AP and PD, and no consensus has yet been reached.
We evaluated and compared the NMS and their association with life quality in patients with AP and PD.
This cross-sectional observational report at a single-centre enrolling 204 patients (155 PD, 49 AP (27 MSA), and 22 PSP) from a tertiary care hospital's movement disorder clinic. We used Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS UPDRS)-III and modified Hoehn and Yahr (H&Y) to compute a motor score and disease severity, respectively. We assessed patients' mental capabilities, such as cognitive impairment, through a Mini-Mental State Examination (MMSE). Meanwhile, the NMSS determined the NMSs. Quality of life (QoL) was estimated by PD Questionnaire-39 (PDQ-39).
We observed insignificant differences between the PD and atypical parkinsonian syndrome (APS) groups based on disease duration and gender. Worsened motor disability and disease severity were observed in AP (PSP>MSA) ( < .001). The mean NMSS scores for PD, PSP and MSA were 23.7 ± 27.9, 47.6 ± 41.3 and 65.6 ± 35.5, respectively ( < .05). MSA had a comparatively high score for sexual, cardiovascular and urinary domains, while PSP scored higher for memory/attention domains. In contrast, PD group revealed significantly lower scores for perceptual and sexual domains.
Compared to PD, NMS was severe and highly prevalent among AP (MSA > PSP), which could be confirmed through the prevalence of sexual cardiovascular and urinary domains in MSA, while attention and mood/cognition, and sleep in PSP.
非运动症状（NMS）常常被忽视，但它们对帕金森病（PD）或非典型帕金森综合征（AP）的进展有显著影响，后者包括多系统萎缩（MSA）、进行性核上性麻痹（PSP）。此外，AP和PD的非运动症状量表（NMSS）评分存在差异，尚未达成共识。
我们评估并比较了AP和PD患者的非运动症状及其与生活质量的关联。
这项单中心横断面观察性报告纳入了一家三级护理医院运动障碍门诊的204例患者（155例PD、49例AP（27例MSA）和22例PSP）。我们分别使用运动障碍协会统一帕金森病评定量表（MDS UPDRS）-III和改良的Hoehn和Yahr（H&Y）来计算运动评分和疾病严重程度。我们通过简易精神状态检查表（MMSE）评估患者的心理能力，如认知障碍。同时，NMSS用于确定非运动症状。生活质量（QoL）通过帕金森病问卷-39（PDQ-39）进行评估。
基于病程和性别，我们观察到PD组和非典型帕金森综合征（APS）组之间无显著差异。在AP（PSP>MSA）中观察到运动功能障碍和疾病严重程度恶化（<0.001）。PD、PSP和MSA的平均NMSS评分分别为23.7±27.9、47.6±41.3和65.6±35.5（<0.05）。MSA在性功能、心血管和泌尿系统方面得分相对较高，而PSP在记忆/注意力方面得分较高。相比之下，PD组在感知和性功能方面得分显著较低。
与PD相比，NMS在AP（MSA>PSP）中更为严重且普遍，这可以通过MSA中性功能、心血管和泌尿系统方面的普遍性，以及PSP中的注意力、情绪/认知和睡眠方面得到证实。
