[Autonomic disorders in Parkinson's disease].Ann Acad Med Stetin. 2011; 57(1):11-5; discussion 16.AA
Autonomic disorders (AD) are one of non-motor symptoms in Parkinson's disease (PD). The aim of this study was to assess the frequency of AD in PD patients and their relationship with age, gender, disease duration, treatment duration, L-dopa dose, and disease severity.
MATERIAL AND METHODS
101 patients with PD were recruited. Anamnesis was recorded with a focus on orthostatic hypotension, sialorrhea, dysphagia, nausea/vomiting, loss of appetite, weight loss, constipation, nycturia, urgency, pollakiuria, difficulties in starting miction, urinary incontinence, erectile dysfunction, sweating, heat/cold intolerance, and seborrhea. Mann-Whitney test and Pearson's chi2 test were used for statistical analysis.
The study group comprised 53 men and 48 women, aged 42-84 years, mean age 67.69 years. The disease duration was 1-25 years, mean 6.5 years, L-dopa treatment duration was 1-20 years, mean 6.04 years, L-dopa dose was 300-2000 mg/24 h, mean 636 mg/24 h, UPDRS score was 8-103 pts, mean 36.38 pts. Orthostatic hypotension was found in approximately 16% of the patients. As regards gastrointestinal disorders, more than 40% of patients suffered from constipation, more than 32% from dysphagia, almost 28% from sialorrhea, approximately 11% from loss of appetite, 6.93% from weight loss, 2% from nausea/vomiting. The distribution of urogenital disorders was as follows: almost 85% of patients had erectile dysfunction, almost 57% nycturia, 24.78% urinary incontinence, approximately 22% pollakiuria, and almost 12% urgency and difficulties with erection. One-third of PD patients suffered from seborrhea, 16.83% from sweating, and almost 9% from heat/cold intolerance.
The most frequent AD in PD were: erectile dysfunction, nycturia, constipation, dysphagia, and seborrhea. Age correlated with orthostatic hypotension, constipation, and urinary incontinence, and with erectile dysfunction in men. Women were predisposed to weight loss and sweating. Men were predisposed to difficulties in starting miction. Disease duration correlated with constipation, nycturia, and urinary incontinence; L-dopa treatment duration correlated with nausea/vomiting and constipation; L-dopa dose correlated with nausea/vomiting, constipation, urgency, and heat/cold intolerance; disease stage correlated with sialorrhea, constipation, sweating, and heat/cold intolerance.