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The spectrum of nonmotor symptoms in early Parkinson disease

Identifieur interne : 000390 ( Ncbi/Merge ); précédent : 000389; suivant : 000391

The spectrum of nonmotor symptoms in early Parkinson disease

Auteurs : Tien Khoo ; Alison Yarnall ; Gordon Duncan ; Shirley Coleman ; John O ; David Brooks ; Roger Barker ; David Burn

Source :

RBID : PMC:3589180

Abstract

Objective:

Nonmotor symptoms (NMS) are common in patients with established Parkinson disease (PD) but their frequency in early PD has not been extensively studied. Our aim was to determine the frequency of NMS in a cohort of patients with newly diagnosed PD.

Methods:

A total of 159 patients with early PD and 99 healthy controls participated in this study. NMS were screened for using the Nonmotor Symptom Questionnaire. Other assessments included measures of motor disability (Movement Disorders Society–revised Unified Parkinson's Disease Rating Scale [MDS-UPDRS]), disease severity (Hoehn & Yahr staging), depression (Geriatric Depression Scale), and global cognitive function (Mini-Mental State Examination and Montreal Cognitive Assessment).

Results:

The PD group reported a significantly greater number of NMS compared with controls (8.4 [4.3] vs 2.8 [2.6]). In the PD group, the most commonly experienced NMS were excessive saliva, forgetfulness, urinary urgency, hyposmia, and constipation. Patients with higher MDS-UPDRS III scores and those with the postural instability gait subtype experienced a greater number of NMS.

Conclusion:

NMS are common in early PD and reflect the multisystem nature of the disorder. Even in the earliest stages of PD, NMS may be detrimental to patients' functional status and sense of well-being.


Url:
DOI: 10.1212/WNL.0b013e31827deb74
PubMed: 23319473
PubMed Central: 3589180

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PMC:3589180

Le document en format XML

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<title>Objective:</title>
<p>Nonmotor symptoms (NMS) are common in patients with established Parkinson disease (PD) but their frequency in early PD has not been extensively studied. Our aim was to determine the frequency of NMS in a cohort of patients with newly diagnosed PD.</p>
</sec>
<sec>
<title>Methods:</title>
<p>A total of 159 patients with early PD and 99 healthy controls participated in this study. NMS were screened for using the Nonmotor Symptom Questionnaire. Other assessments included measures of motor disability (Movement Disorders Society–revised Unified Parkinson's Disease Rating Scale [MDS-UPDRS]), disease severity (Hoehn & Yahr staging), depression (Geriatric Depression Scale), and global cognitive function (Mini-Mental State Examination and Montreal Cognitive Assessment).</p>
</sec>
<sec>
<title>Results:</title>
<p>The PD group reported a significantly greater number of NMS compared with controls (8.4 [4.3] vs 2.8 [2.6]). In the PD group, the most commonly experienced NMS were excessive saliva, forgetfulness, urinary urgency, hyposmia, and constipation. Patients with higher MDS-UPDRS III scores and those with the postural instability gait subtype experienced a greater number of NMS.</p>
</sec>
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<title>Conclusion:</title>
<p>NMS are common in early PD and reflect the multisystem nature of the disorder. Even in the earliest stages of PD, NMS may be detrimental to patients' functional status and sense of well-being.</p>
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<p>NONE</p>
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<p>NONE</p>
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<title>Funding for Travel or Speaker Honoraria:</title>
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<p>Teva-Lundbeck, speaker honorariaTeva-Lundbeck, educational grantUCB Pharma and GSK, travel grant</p>
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<p>NONE</p>
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<title>Patents:</title>
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<p>NONE</p>
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<list list-type="order">
<title>Publishing Royalties:</title>
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<p>NONE</p>
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<p>NONE</p>
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<p>NONE</p>
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<p>NONE</p>
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<title>Other Activities:</title>
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<p>NONE</p>
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<p>NONE</p>
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<title>Research Support, Commercial Entities:</title>
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<p>NONE</p>
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<title>Research Support, Government Entities:</title>
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<p>NONE</p>
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<p>NONE</p>
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<title>Stock/Stock Options/Board of Directors Compensation:</title>
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<p>NONE</p>
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<p>NONE</p>
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<p>NONE</p>
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<p>NONE</p>
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<title>Stock/Stock Options, Medical Equipment & Materials:</title>
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<p>NONE</p>
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<p>NONE</p>
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<degrees>MBBS</degrees>
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<p>NONE</p>
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<p>NONE</p>
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<list list-type="order">
<title>Funding for Travel or Speaker Honoraria:</title>
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<p>(1) Received travel funds from TEVA-Lundbeck for attendinga conference.(2) Received travel funds from UCB for attending a conference.(3) Received speaker honoraria from TEVA-lundbeck.</p>
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<p>NONE</p>
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<list list-type="order">
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<p>NONE</p>
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<p>NONE</p>
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<p>NONE</p>
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<title>Research Support, Academic Entities:</title>
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<p>NONE</p>
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</p>
<p>
<list list-type="order">
<title>Research Support, Foundations and Societies:</title>
<list-item>
<p>(1) Michael J Fox Foundation(2) Lockhart Newcastle University fund</p>
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</p>
<p>
<list list-type="order">
<title>Stock/Stock Options/Board of Directors Compensation:</title>
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<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>License Fee Payments, Technology or Inventions:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Royalty Payments, Technology or Inventions:</title>
<list-item>
<p>NONE</p>
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<p>NONE</p>
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</p>
<p>
<list list-type="order">
<title>Stock/Stock Options, Medical Equipment & Materials:</title>
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<p>NONE</p>
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<list-item>
<p>NONE</p>
</list-item>
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<contrib contrib-type="author">
<name>
<surname>Duncan</surname>
<given-names>Gordon W.</given-names>
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<p>
<list list-type="order">
<title>Scientific Advisory Boards:</title>
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<p>NONE</p>
</list-item>
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</p>
<p>
<list list-type="order">
<title>Gifts:</title>
<list-item>
<p>NONE</p>
</list-item>
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</p>
<p>
<list list-type="order">
<title>Funding for Travel or Speaker Honoraria:</title>
<list-item>
<p>NONE</p>
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<list list-type="order">
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<p>NONE</p>
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<p>
<list list-type="order">
<title>Patents:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Publishing Royalties:</title>
<list-item>
<p>NONE</p>
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<p>
<list list-type="order">
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<p>NONE</p>
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<list-item>
<p>NONE</p>
</list-item>
</list>
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<p>
<list list-type="order">
<title>Speakers' Bureaus:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Other Activities:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Clinical Procedures or Imaging Studies:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Research Support, Commercial Entities:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
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<list-item>
<p>NONE</p>
</list-item>
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</p>
<p>
<list list-type="order">
<title>Research Support, Academic Entities:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Research Support, Foundations and Societies:</title>
<list-item>
<p>1) Parkinson's UK (Grant reference number J-0802), (2) Lockhart Parkinson's Disease Fellowship</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Stock/Stock Options/Board of Directors Compensation:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>License Fee Payments, Technology or Inventions:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Royalty Payments, Technology or Inventions:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Stock/Stock Options, Research Sponsor:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Stock/Stock Options, Medical Equipment & Materials:</title>
<list-item>
<p>NONE</p>
</list-item>
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<p>
<list list-type="order">
<title>Legal Proceedings:</title>
<list-item>
<p>NONE</p>
</list-item>
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</p>
</author-comment>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Coleman</surname>
<given-names>Shirley</given-names>
</name>
<degrees>PhD</degrees>
<author-comment content-type="disclosure">
<p>
<list list-type="order">
<title>Scientific Advisory Boards:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Gifts:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Funding for Travel or Speaker Honoraria:</title>
<list-item>
<p>Informa, contribution to travel expenses to speak atmeeting Process Validation22nd - 23rd November 2011Andels Hotel Berlin, Germany</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Editorial Boards:</title>
<list-item>
<p>Quality Technology and Quantitative Management , AssociateEditor, from 2008 to presentTotal Quality Management, Associate Editor, 2006 to present</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Patents:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Publishing Royalties:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Employment, Commercial Entity:</title>
<list-item>
<p>Newcastle University, Principal Research Associate</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Consultancies:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Speakers' Bureaus:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Other Activities:</title>
<list-item>
<p>NONE</p>
</list-item>
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</p>
<p>
<list list-type="order">
<title>Clinical Procedures or Imaging Studies:</title>
<list-item>
<p>NONE</p>
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<p>
<list list-type="order">
<title>Research Support, Commercial Entities:</title>
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<p>NONE</p>
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</p>
<p>
<list list-type="order">
<title>Research Support, Academic Entities:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Research Support, Foundations and Societies:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Stock/Stock Options/Board of Directors Compensation:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>License Fee Payments, Technology or Inventions:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Royalty Payments, Technology or Inventions:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Stock/Stock Options, Research Sponsor:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Stock/Stock Options, Medical Equipment & Materials:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Legal Proceedings:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
</author-comment>
</contrib>
<contrib contrib-type="author">
<name>
<surname>O’Brien</surname>
<given-names>John T.</given-names>
</name>
<degrees>DM</degrees>
<author-comment content-type="disclosure">
<p>
<list list-type="order">
<title>Scientific Advisory Boards:</title>
<list-item>
<p>(1) GE Healthcare(2) Servier(3) Bayer Healthcare</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Gifts:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Funding for Travel or Speaker Honoraria:</title>
<list-item>
<p>(1) Pfizer, speaker honoraria(2) GE Healthcare, speaker honoraria(3) Eisai, speaker honoraria(4) Shire, speaker honoraria(5) Lundbeck, speaker honoraria(6) Lilly, speaker honoraria(7) Novartis, speaker honoraria</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Editorial Boards:</title>
<list-item>
<p>(1) Psychological Medicine, Editorial Board(2) International Psychogeriatrics, Deputy Editor(3) American Journal of Geriatric Psychiatry, Editorial Board</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Patents:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Publishing Royalties:</title>
<list-item>
<p>(1) Burns A, O'Brien JT, Ames D (eds) (2005) Dementia, 3rd edition. Hodder Arnold, London.(2) Ames D, Burns A O'Brien JT (eds) (2010) Dementia, 4th edition. Hodder, Edward Arnold, London (published November 2010).(3) O'Brien J, McKeith I, Ames D, Chiu E (2006). Dementia with Lewy Bodies and Parkinson's disease dementia. Taylor and Francis, London.</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Employment, Commercial Entity:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Consultancies:</title>
<list-item>
<p>(1) GE Healthcare(2) Servier(3) Bayer Healthcare</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Speakers' Bureaus:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Other Activities:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Clinical Procedures or Imaging Studies:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Research Support, Commercial Entities:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Research Support, Government Entities:</title>
<list-item>
<p>(1) Parkinson's Disease Society 01.10.2007-30.09.2010;(2) Sir Jules Thorn Charitable Trust, 01.02.2006-31.01.2011;(3) DoH/Wellcome Trust, 01.06.2006-31.05.2011;(4) Medical Research Council, 01.11.2007-31.12.2013;(5) Parkinson's Disease Society, 01.02.2009-31.01.2014;(6) Member of the NIHR College of Senior Investigators, 01.04.2009-31.03.2014;(7) NIHR, 01.03.2010-28.02.2013;(8) Wellcome Trust Intermediate Fellowship, 01.05.2010-30.04.2013;(9) NIHR-RfPB, 01.08.2010-31.07.2012.(10) The Food Standards Agency, 01.12.2010-31.07.2013. (11) BUPA/Alzheimer's Society, 01.12.2010-30.11.2012. (12) British Heart Foundation/The Stroke Association, 01.01.2011-31.12.2015. (13) HTA, 01.03.2011-30.04.2014. (14) Alzheimer's Research Trust, 01.03.2011-31.08.2012.</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Research Support, Academic Entities:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Research Support, Foundations and Societies:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Stock/Stock Options/Board of Directors Compensation:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>License Fee Payments, Technology or Inventions:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Royalty Payments, Technology or Inventions:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Stock/Stock Options, Research Sponsor:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Stock/Stock Options, Medical Equipment & Materials:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Legal Proceedings:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
</author-comment>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Brooks</surname>
<given-names>David J.</given-names>
</name>
<degrees>MD</degrees>
<author-comment content-type="disclosure">
<p>
<list list-type="order">
<title>Scientific Advisory Boards:</title>
<list-item>
<p>Member of the German Dementia Network and Austrian FWF Advisory Boards</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Gifts:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Funding for Travel or Speaker Honoraria:</title>
<list-item>
<p>Honoraria from GlaxoSmithKline, Genzyme, TEVA for attending ABs.</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Editorial Boards:</title>
<list-item>
<p>Associate Editor of Brain. Member of Synapse, J Neural Transmission, Clin Neurol and Neurosurg, J Parkinson's Disease, Parkinsonisms and related disorders, Basal Ganglia editorial boards</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Patents:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Publishing Royalties:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Employment, Commercial Entity:</title>
<list-item>
<p>Part time employee of GE Healthcare</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Consultancies:</title>
<list-item>
<p>Shire Pharmaceuticals</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Speakers' Bureaus:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Other Activities:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Clinical Procedures or Imaging Studies:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Research Support, Commercial Entities:</title>
<list-item>
<p>Parkinsons UKMedical Research Council programme grant funding</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Research Support, Government Entities:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Research Support, Academic Entities:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Research Support, Foundations and Societies:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Stock/Stock Options/Board of Directors Compensation:</title>
<list-item>
<p>GE Healthcare</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>License Fee Payments, Technology or Inventions:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Royalty Payments, Technology or Inventions:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Stock/Stock Options, Research Sponsor:</title>
<list-item>
<p>GE Healthcare</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Stock/Stock Options, Medical Equipment & Materials:</title>
<list-item>
<p>GE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Legal Proceedings:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
</author-comment>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Barker</surname>
<given-names>Roger A.</given-names>
</name>
<degrees>PhD</degrees>
<author-comment content-type="disclosure">
<p>
<list list-type="order">
<title>Scientific Advisory Boards:</title>
<list-item>
<p>Teva Lundbeck, UK.</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Gifts:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Funding for Travel or Speaker Honoraria:</title>
<list-item>
<p>Teva Lundbeck, Positive steps Meetings 2010, 2011, 2012.MDS Meeting Toronto 2011, Dublin 2012.</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Editorial Boards:</title>
<list-item>
<p>Co-Editor in Chief, Journal of Neurology.Editorial Boaard of Journal of Parkinson's Disease; Synapse; Regenerative Medicine.</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Patents:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Publishing Royalties:</title>
<list-item>
<p>Neuroscience at a glance. 5th Edition. 2012.</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Employment, Commercial Entity:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Consultancies:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Speakers' Bureaus:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Other Activities:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Clinical Procedures or Imaging Studies:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Research Support, Commercial Entities:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Research Support, Government Entities:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Research Support, Academic Entities:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Research Support, Foundations and Societies:</title>
<list-item>
<p>I have recieved funding from the EU; Parkinson's UK; CHDI; Cure PD; Rosetrees trust; Michael J Fox Foundation.</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Stock/Stock Options/Board of Directors Compensation:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>License Fee Payments, Technology or Inventions:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Royalty Payments, Technology or Inventions:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Stock/Stock Options, Research Sponsor:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Stock/Stock Options, Medical Equipment & Materials:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Legal Proceedings:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
</author-comment>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Burn</surname>
<given-names>David J.</given-names>
</name>
<degrees>MD</degrees>
<author-comment content-type="disclosure">
<p>
<list list-type="order">
<title>Scientific Advisory Boards:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Gifts:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Funding for Travel or Speaker Honoraria:</title>
<list-item>
<p>Teva-Lundbeck: payment for speaking / chairing annual meetings in 2010-2012 in UKUCB: speaker at national meetings 2010 & 2011</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Editorial Boards:</title>
<list-item>
<p>Movement Disorder Journal: Associate Editor (1st Jan 2010-present)</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Patents:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Publishing Royalties:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Employment, Commercial Entity:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Consultancies:</title>
<list-item>
<p>GSK in 2011-2012(payment made to Newcastle University)</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Speakers' Bureaus:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Other Activities:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Clinical Procedures or Imaging Studies:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Research Support, Commercial Entities:</title>
<list-item>
<p>GSK</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Research Support, Government Entities:</title>
<list-item>
<p>Multicentre UK Study of the acetylcholinesterase inhibitor donepezil in early dementia associated with Parkinson's disease (MUSTARDD-PD). NIHR Health Technology Assessment Programme Project REF: 08/14/13: 1st Sept 2010 - 31st Aug 2015; (Burn DJ, Barker RA, Braithwaite B, Burns A, Clarke CE, Hindle JV, Knapp M, Lees AJ, Leroi I, McColl E, McKeith IG, O'Brien JT, Steen IN, Wheatley K).</p>
<p>A Biomedical Research Unit in Lewy Body Dementia. NIHR: 1st April 2012 - 31st March 2017; (Burn DJ, McKeith IG, O'Brien JT, Kirkwood TBL, Chinnery PF, Ford GA).</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Research Support, Academic Entities:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Research Support, Foundations and Societies:</title>
<list-item>
<p>Visual symptoms in Parkinson's disease and Parkinson's disease dementia: Association with ocular and retinal pathology, visuo-perceptual deficits and impact on daily living and quality of life. Parkinson's UK: November 2007-October 2010; (Archibald N, Mosimann UP, Clarke MP, Burn DJ).</p>
<p>Predicting Dementia in Parkinson's disease: A genotypic and phenotypic study (ICICLE-PD). Parkinson's UK REF J0802, UK: October 2007 - September 2012;(Burn DJ, Barker RA, Brooks DJ, O'Brien JT, McKeith IG, Chinnery PF, Owen AM, Brayne CEG, Robbins T, Sawcer S, Coleman S).</p>
<p>The Parkinson's Repository of Biomarkers and Networked Datasets (PROBAND) programme: A UK national clinical consortium linking novel biomarker research to clinical expression, and progression rates, in Parkinson's disease. Parkinson's UK: 2011-2015; (Grosset D, Burn DJ, Barker RA, Ben-Shlomo Y, Bajaj N, Hardy J, Wood NW, Morris HR).</p>
<p>Apomorphine: A modifier of amyloid deposition in Parkinson's disease? Parkinson's UK REF K-1101: October 2011 - April 2012;(Burn DJ, Revesz T, Lees AJ).</p>
<p>Michael J Fox FoundationClinical trial to compare cognitive scales. Michael J Fox Foundation: 1st October 2011 - 30th September 2016; (Burn DJ, Weintraub D).</p>
<p>Predicting cognitive profiles in Parkinson's disease: A multimodal approach. Michael J Fox Foundation: 1st November 2011 - 31st October 2013; (Burn DJ, Rochester L, O'Brien JT, Coleman SY, Baker MR).</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Stock/Stock Options/Board of Directors Compensation:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>License Fee Payments, Technology or Inventions:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Royalty Payments, Technology or Inventions:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Stock/Stock Options, Research Sponsor:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Stock/Stock Options, Medical Equipment & Materials:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
<p>
<list list-type="order">
<title>Legal Proceedings:</title>
<list-item>
<p>NONE</p>
</list-item>
</list>
</p>
</author-comment>
</contrib>
</contrib-group>
<aff>From the Institute for Ageing and Health (T.K.K., A.J.Y., G.W.D., J.T.O., D.J. Burn) and Industrial Statistics Research Unit (S.C.), Newcastle University, Newcastle upon Tyne; Imperial College (D.J. Brooks), MRC Clinical Sciences Centre, London; and Cambridge Centre for Brain Repair (R.A.B.), Cambridge University, Cambridge, UK.</aff>
<author-notes>
<corresp>Correspondence to Dr. Khoo:
<email>khootkheng@yahoo.com</email>
</corresp>
<fn fn-type="financial-disclosure">
<p>Go to
<ext-link ext-link-type="uri" xlink:href="http://neurology.org/">Neurology.org</ext-link>
for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.</p>
</fn>
</author-notes>
<pub-date pub-type="ppub">
<day>15</day>
<month>1</month>
<year>2013</year>
</pub-date>
<pub-date pub-type="pmc-release">
<day>15</day>
<month>7</month>
<year>2013</year>
</pub-date>
<pmc-comment> PMC Release delay is 6 months and 0 days and was based on the . </pmc-comment>
<volume>80</volume>
<issue>3</issue>
<fpage>276</fpage>
<lpage>281</lpage>
<history>
<date date-type="received">
<day>9</day>
<month>5</month>
<year>2012</year>
</date>
<date date-type="accepted">
<day>30</day>
<month>8</month>
<year>2012</year>
</date>
</history>
<permissions>
<copyright-statement>© 2013 American Academy of Neurology</copyright-statement>
<copyright-year>2013</copyright-year>
<copyright-holder>American Academy of Neurology</copyright-holder>
</permissions>
<self-uri xlink:title="pdf" xlink:type="simple" xlink:href="WNL204588.pdf"></self-uri>
<abstract>
<sec>
<title>Objective:</title>
<p>Nonmotor symptoms (NMS) are common in patients with established Parkinson disease (PD) but their frequency in early PD has not been extensively studied. Our aim was to determine the frequency of NMS in a cohort of patients with newly diagnosed PD.</p>
</sec>
<sec>
<title>Methods:</title>
<p>A total of 159 patients with early PD and 99 healthy controls participated in this study. NMS were screened for using the Nonmotor Symptom Questionnaire. Other assessments included measures of motor disability (Movement Disorders Society–revised Unified Parkinson's Disease Rating Scale [MDS-UPDRS]), disease severity (Hoehn & Yahr staging), depression (Geriatric Depression Scale), and global cognitive function (Mini-Mental State Examination and Montreal Cognitive Assessment).</p>
</sec>
<sec>
<title>Results:</title>
<p>The PD group reported a significantly greater number of NMS compared with controls (8.4 [4.3] vs 2.8 [2.6]). In the PD group, the most commonly experienced NMS were excessive saliva, forgetfulness, urinary urgency, hyposmia, and constipation. Patients with higher MDS-UPDRS III scores and those with the postural instability gait subtype experienced a greater number of NMS.</p>
</sec>
<sec>
<title>Conclusion:</title>
<p>NMS are common in early PD and reflect the multisystem nature of the disorder. Even in the earliest stages of PD, NMS may be detrimental to patients' functional status and sense of well-being.</p>
</sec>
</abstract>
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</pmc>
<affiliations>
<list></list>
<tree>
<noCountry>
<name sortKey="Barker, Roger A" sort="Barker, Roger A" uniqKey="Barker R" first="Roger" last="Barker">Roger Barker</name>
<name sortKey="Brooks, David J" sort="Brooks, David J" uniqKey="Brooks D" first="David" last="Brooks">David Brooks</name>
<name sortKey="Burn, David J" sort="Burn, David J" uniqKey="Burn D" first="David" last="Burn">David Burn</name>
<name sortKey="Coleman, Shirley" sort="Coleman, Shirley" uniqKey="Coleman S" first="Shirley" last="Coleman">Shirley Coleman</name>
<name sortKey="Duncan, Gordon W" sort="Duncan, Gordon W" uniqKey="Duncan G" first="Gordon" last="Duncan">Gordon Duncan</name>
<name sortKey="Khoo, Tien K" sort="Khoo, Tien K" uniqKey="Khoo T" first="Tien" last="Khoo">Tien Khoo</name>
<name sortKey="O Rien, John T" sort="O Rien, John T" uniqKey="O Rien J" first="John" last="O">John O</name>
<name sortKey="Yarnall, Alison J" sort="Yarnall, Alison J" uniqKey="Yarnall A" first="Alison" last="Yarnall">Alison Yarnall</name>
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</affiliations>
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