Gonaboyina Deepak S, Das Pragateshnu, Pradhan Nikhilesh, Dash Prerana, Venugopalan Vipin, Dash Santosh
Department of Neurology, Kalinga Institute of Medical Sciences, Bhubaneswar, IND.
Cureus. 2025 Jul 9;17(7):e87633. doi: 10.7759/cureus.87633. eCollection 2025 Jul.
Non-motor symptoms (NMS) in Parkinson's disease (PD) can influence cognition, emotion, sleep, and autonomic systems. NMS frequently precede motor symptoms, underscoring the necessity for a thorough comprehension of these symptoms, especially in heterogeneous populations like India. This study aims to explore the NMS of PD in a cohort from eastern India.
Sixty consecutive patients with PD were enrolled in this study after considering the inclusion and exclusion criteria. Informed consent was obtained from each patient after ethical clearance from the institutional ethics committee. Data were collected by using the standardized Movement Disorder Society Non-Motor Symptoms Rating Scale (MDS-NMS) to assess various NMS. Additionally, the study categorized patients into clinical subtypes based on their predominant symptoms and it analyzed how NMS manifested in each subtype. The correlation between NMS was also assessed.
Gastrointestinal (GI) issues were the most common NMS, affecting all 60 (100%) patients. Depression affected 59 (98.33%) patients, followed by anxiety in 57 (95%) patients. Only two (3.33%) patients reported sexual dysfunction, while 55 (91.67%) patients reported pain, and 54 (90%) patients reported cognitive impairment. Constipation was more common among symptoms of the GI domain. Twenty-seven (45%) patients had developed at least one NMS prior to the diagnosis of PD. Younger patients (<60 years) tend to experience more severe emotional symptoms like depression and anxiety. Older patients (60-80 years) showed increasing severity of physical symptoms like pain, fatigue, and GI issues, along with cognitive decline. No statistically significant differences were observed for NMS severity between the akinetic-rigid versus tremor-predominant subtypes of PD.
The findings emphasize that NMS are prevalent in nearly all PD patients. Addressing NMS in clinical practice is crucial for improving patient outcomes. Particularly in India, where these symptoms may be underdiagnosed, the study highlights the need for routine screening and management of NMS to enhance overall care strategies for PD patients.
帕金森病（PD）中的非运动症状（NMS）可影响认知、情绪、睡眠和自主神经系统。NMS常先于运动症状出现，这凸显了全面了解这些症状的必要性，尤其是在印度这样的异质人群中。本研究旨在探索印度东部一个队列中PD的NMS。
在考虑纳入和排除标准后，连续纳入60例PD患者。经机构伦理委员会伦理批准后，获得了每位患者的知情同意。使用标准化的运动障碍协会非运动症状评定量表（MDS-NMS）收集数据，以评估各种NMS。此外，该研究根据患者的主要症状将其分为临床亚型，并分析了每种亚型中NMS的表现形式。还评估了NMS之间的相关性。
胃肠道（GI）问题是最常见的NMS，影响了所有60例（100%）患者。抑郁影响了59例（98.33%）患者，其次是焦虑，有57例（95%）患者。只有2例（3.33%）患者报告有性功能障碍，而55例（91.67%）患者报告有疼痛，54例（90%）患者报告有认知障碍。便秘在GI领域症状中更为常见。27例（45%）患者在PD诊断之前就已出现至少一种NMS。年轻患者（<60岁）往往经历更严重的情绪症状，如抑郁和焦虑。老年患者（60 - 80岁）身体症状如疼痛、疲劳和GI问题的严重程度增加，同时伴有认知能力下降。在PD的运动不能-强直型与震颤为主型亚型之间，未观察到NMS严重程度的统计学显著差异。
研究结果强调NMS在几乎所有PD患者中都很普遍。在临床实践中处理NMS对于改善患者预后至关重要。特别是在印度，这些症状可能未得到充分诊断，该研究强调了对NMS进行常规筛查和管理的必要性，以加强PD患者的整体护理策略。
