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Dopaminergic Effect on Non-Motor Symptoms in Late Stage Parkinson's Disease.
J Parkinsons Dis. 2018; 8(3):409-420.JP

Abstract

BACKGROUND

Non-motor symptoms (NMS) are common in late stage Parkinson's disease (PD), as the frequency and severity of most of these symptoms increase with advancing disease.

OBJECTIVE

To assess effect of dopaminergic therapy on NMS in late stage PD and to investigate relationships between dopaminergic effect on NMS and on motor function.

METHOD

Thirty PD patients in Hoehn and Yahr (HY) stages IV and V in "on" were included. Dopaminergic effect on non-motor symptomatology was assessed by the modified version of the Non-Motor Symptoms Scale (NMSS) in the "off" and the "on" state during a standardized L-dopa test, in parallel also assessing motor function.

RESULTS

NMS were common and many of the symptoms occurred in >80% of the individuals. The highest NMSS scores were seen within the NMSS domains 3: mood/apathy and 7: urinary in both the "off" and the "on" state. There was a statistically significant (p < 0.001) improvement in the modified NMSS total score (median) from 79 in "off" to 64 in "on". There were statistically significant differences between the "off" and the "on" state for domains 2: sleep/fatigue, 3: mood/apathy, 5: attention/memory, 6: gastrointestinal and 7: urinary. The differences in the NMSS score between the "off" and the "on" state were in general larger for motor responders than for motor non-responders. In motor non-responders, differences of the NMSS score between the "off" and the "on" state were found for the total score, domain 3: mood/apathy and its item 11-flat moods.

CONCLUSION

There is an effect of dopaminergic medication on NMS in late stage PD, to some extent also for those with a non-significant response on motor function during L-dopa test. It is therefore of importance to optimize dopaminergic therapy in order to give the most effective symptomatic treatment possible.

Authors

No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

30056433

Citation

Rosqvist, Kristina, et al. "Dopaminergic Effect On Non-Motor Symptoms in Late Stage Parkinson's Disease." Journal of Parkinson's Disease, vol. 8, no. 3, 2018, pp. 409-420.
Rosqvist K, Odin P, Hagell P, et al. Dopaminergic Effect on Non-Motor Symptoms in Late Stage Parkinson's Disease. J Parkinsons Dis. 2018;8(3):409-420.
Rosqvist, K., Odin, P., Hagell, P., Iwarsson, S., Nilsson, M. H., & Storch, A. (2018). Dopaminergic Effect on Non-Motor Symptoms in Late Stage Parkinson's Disease. Journal of Parkinson's Disease, 8(3), 409-420. https://doi.org/10.3233/JPD-181380
Rosqvist K, et al. Dopaminergic Effect On Non-Motor Symptoms in Late Stage Parkinson's Disease. J Parkinsons Dis. 2018;8(3):409-420. PubMed PMID: 30056433.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Dopaminergic Effect on Non-Motor Symptoms in Late Stage Parkinson's Disease. AU - Rosqvist,Kristina, AU - Odin,Per, AU - Hagell,Peter, AU - Iwarsson,Susanne, AU - Nilsson,Maria H, AU - Storch,Alexander, PY - 2018/7/30/pubmed PY - 2019/10/16/medline PY - 2018/7/30/entrez KW - Parkinson’s disease KW - apathy KW - fatigue KW - fluctuations KW - late stage KW - levodopa KW - levodopa test KW - mood KW - non-motor symptoms KW - sleep SP - 409 EP - 420 JF - Journal of Parkinson's disease JO - J Parkinsons Dis VL - 8 IS - 3 N2 - BACKGROUND: Non-motor symptoms (NMS) are common in late stage Parkinson's disease (PD), as the frequency and severity of most of these symptoms increase with advancing disease. OBJECTIVE: To assess effect of dopaminergic therapy on NMS in late stage PD and to investigate relationships between dopaminergic effect on NMS and on motor function. METHOD: Thirty PD patients in Hoehn and Yahr (HY) stages IV and V in "on" were included. Dopaminergic effect on non-motor symptomatology was assessed by the modified version of the Non-Motor Symptoms Scale (NMSS) in the "off" and the "on" state during a standardized L-dopa test, in parallel also assessing motor function. RESULTS: NMS were common and many of the symptoms occurred in >80% of the individuals. The highest NMSS scores were seen within the NMSS domains 3: mood/apathy and 7: urinary in both the "off" and the "on" state. There was a statistically significant (p < 0.001) improvement in the modified NMSS total score (median) from 79 in "off" to 64 in "on". There were statistically significant differences between the "off" and the "on" state for domains 2: sleep/fatigue, 3: mood/apathy, 5: attention/memory, 6: gastrointestinal and 7: urinary. The differences in the NMSS score between the "off" and the "on" state were in general larger for motor responders than for motor non-responders. In motor non-responders, differences of the NMSS score between the "off" and the "on" state were found for the total score, domain 3: mood/apathy and its item 11-flat moods. CONCLUSION: There is an effect of dopaminergic medication on NMS in late stage PD, to some extent also for those with a non-significant response on motor function during L-dopa test. It is therefore of importance to optimize dopaminergic therapy in order to give the most effective symptomatic treatment possible. SN - 1877-718X UR - https://www.unboundmedicine.com/medline/citation/30056433/Dopaminergic_Effect_on_Non_Motor_Symptoms_in_Late_Stage_Parkinson's_Disease_ L2 - https://content.iospress.com/openurl?genre=article&amp;id=doi:10.3233/JPD-181380 DB - PRIME DP - Unbound Medicine ER -