Variation in recent onset Parkinson's disease: Implications for prodromal detection

Swallow, D. M.A. et al. (2016) Variation in recent onset Parkinson's disease: Implications for prodromal detection. Journal of Parkinson's Disease, 6(2), pp. 289-300. (doi: 10.3233/JPD-150741) (PMID:27003780) (PMCID:PMC4927926)

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Abstract

Background: The detection of prodromal Parkinson’s disease (PD) is desirable to test drugs with neuroprotective potential, but will be affected by known disease variations. Objective: To assess the prevalence of four key non-motor prodromal PD markers, and evaluate the sensitivity of case detection when non-motor screening tools for prodromal PD are implemented in an early clinical PD cohort. Methods: Hyposmia (University of Pennsylvania smell identification test ≤15th centile or Sniffin’ Sticks at or ≤10th centile corrected for age and sex), rapid-eye movement sleep behaviour disorder (RBD questionnaire >4), constipation (<1 daily spontaneous bowel motion) and depression (Leeds >6) were recorded in recent onset PD cases, and proposed non-motor screening criteria applied. Results: In 1,719 PD cases, mean age 68.6 years (SD 8.1), 65.5% male, mean disease duration 1.3 years (SD 0.9), 72.2% were hyposmic, 43.3% had RBD, 22.1% depression, and 21.5% constipation. 11.6% of cases had no key non-motor features, 38.8% one, 32.1% two, 15.5% three, and 2.0% all four. Increasing numbers of non-motor features were associated with younger age (p = 0.019), higher motor scores (p < 0.001), more postural instability gait difficulty (PIGD) (p < 0.001), greater cognitive impairment (p < 0.001) and higher total non-motor burden (p < 0.001). Cases with hyposmia alone were younger (p < 0.001), had less severe cognitive (p = 0.006) and other non-motor features (p < 0.001). All screening criteria selected younger patients (p = 0.001, p < 0.001), three of four greater overall non-motor burden (p = 0.005, p < 0.001), and inclusion of RBD more cognitive impairment (p = 0.003, p = 0.001) and PIGD (p = 0.004, p = 0.001). Conclusions: Varying sensitivity levels, and age and phenotype selectivity, are found when different non-motor screening methods to detect prodromal PD are applied to an early clinical PD cohort.

Item Type:Articles
Additional Information:on behalf of PRoBaND Clinical Consortium.
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Grosset, Dr Donald and Grosset, Dr Katherine
Authors: Swallow, D. M.A., Lawton, M. A., Grosset, K. A., Malek, N., Smith, C. R., Bajaj, N., Barker, R. A., Ben-Shlomo, Y., Burn, D., Foltynie, T., Hardy, J., Morris, H. R., Williams, N., Wood, N. W., and Grosset, D. G.
College/School:College of Medical Veterinary and Life Sciences > Institute of Neuroscience and Psychology
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:Journal of Parkinson's Disease
Publisher:IOS Press
ISSN:1877-7171
ISSN (Online):1877-718X
Copyright Holders:Copyright © 2016 IOS Press and the Authors
First Published:First published in Journal of Parkinson's Disease 6(2):289-300
Publisher Policy:Reproduced under a Creative Commons License
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