MovDisordV3, PubMed, Corpus, bibRecord, 000273

Nonmotor predictors for levodopa requirement in de novo patients with Parkinson's disease.

Identifieur interne : 000273 ( PubMed/Corpus ); précédent : 000272; suivant : 000274

Nonmotor predictors for levodopa requirement in de novo patients with Parkinson's disease.

Auteurs : Roberto Erro ; Marina Picillo ; Marianna Amboni ; Marcello Moccia ; Carmine Vitale ; Katia Longo ; Maria Teresa Pellecchia ; Gabriella Santangelo ; Pablo Martinez-Martin ; K Ray Chaudhuri ; Paolo Barone

Source :

Movement disorders : official journal of the Movement Disorder Society [ 1531-8257 ] ; 2015.

RBID : pubmed:25648938

Abstract

The variability in the clinical phenotype of Parkinson's disease (PD) suggests the existence of several subtypes of the disease. Motor heterogeneity of PD is well established, but not nonmotor heterogeneity. At present, we are unable to predict the rate of progression of PD based on robust biomarkers. We aimed to examine the heterogeneity of PD by attempting to identify nonmotor factors associated with the rate of motor progression and functional decline, as measured by the time to reach the need for levodopa therapy during the first 4 years from diagnosis in a cohort of de novo PD patients. The median time to introduction of L-dopa for patients with urinary symptoms was significantly shorter than that for those without (20 vs. 37 months; P = 0.001). Cox's regression models showed that the urinary domain was associated with a higher probability of starting L-dopa (hazard ratio: 2.1; P = 0.002). There was no influence of such confounders as sex, age, baseline motor features, use of dopamine agonists and/or monoamine oxidase B inhibitors, and total L-dopa equivalent daily dosage. Patients with urinary symptoms had higher baseline and follow-up motor and nonmotor disturbances than those without. Our study suggests the existence of a subgroup of patients who show urinary symptoms along with an overall higher motor and nonmotor burden. Such patients are prone to manifest a rapid functional decline over the first 4 years of the disease. Urinary symptoms might be a clinical marker of severity as well as a possible nonmotor subtype of PD.

DOI: 10.1002/mds.26076
PubMed: 25648938

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pubmed:25648938

Le document en format XML

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<author><name sortKey="Erro, Roberto" sort="Erro, Roberto" uniqKey="Erro R" first="Roberto" last="Erro">Roberto Erro</name>
<affiliation><nlm:affiliation>Sobell Department of Motor Neuroscience and Movement Disorders, University College London (UCL) Institute of Neurology, London, United Kingdom; Dipartimento di Scienze Neurologiche e del Movimento, Università di Verona, Policlinico Borgo Roma, Verona, Italy.</nlm:affiliation>
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<author><name sortKey="Picillo, Marina" sort="Picillo, Marina" uniqKey="Picillo M" first="Marina" last="Picillo">Marina Picillo</name>
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<author><name sortKey="Amboni, Marianna" sort="Amboni, Marianna" uniqKey="Amboni M" first="Marianna" last="Amboni">Marianna Amboni</name>
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<author><name sortKey="Moccia, Marcello" sort="Moccia, Marcello" uniqKey="Moccia M" first="Marcello" last="Moccia">Marcello Moccia</name>
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<author><name sortKey="Vitale, Carmine" sort="Vitale, Carmine" uniqKey="Vitale C" first="Carmine" last="Vitale">Carmine Vitale</name>
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<author><name sortKey="Longo, Katia" sort="Longo, Katia" uniqKey="Longo K" first="Katia" last="Longo">Katia Longo</name>
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<author><name sortKey="Pellecchia, Maria Teresa" sort="Pellecchia, Maria Teresa" uniqKey="Pellecchia M" first="Maria Teresa" last="Pellecchia">Maria Teresa Pellecchia</name>
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<author><name sortKey="Santangelo, Gabriella" sort="Santangelo, Gabriella" uniqKey="Santangelo G" first="Gabriella" last="Santangelo">Gabriella Santangelo</name>
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<author><name sortKey="Martinez Martin, Pablo" sort="Martinez Martin, Pablo" uniqKey="Martinez Martin P" first="Pablo" last="Martinez-Martin">Pablo Martinez-Martin</name>
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<author><name sortKey="Chaudhuri, K Ray" sort="Chaudhuri, K Ray" uniqKey="Chaudhuri K" first="K Ray" last="Chaudhuri">K Ray Chaudhuri</name>
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<author><name sortKey="Barone, Paolo" sort="Barone, Paolo" uniqKey="Barone P" first="Paolo" last="Barone">Paolo Barone</name>
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<front><div type="abstract" xml:lang="en">The variability in the clinical phenotype of Parkinson's disease (PD) suggests the existence of several subtypes of the disease. Motor heterogeneity of PD is well established, but not nonmotor heterogeneity. At present, we are unable to predict the rate of progression of PD based on robust biomarkers. We aimed to examine the heterogeneity of PD by attempting to identify nonmotor factors associated with the rate of motor progression and functional decline, as measured by the time to reach the need for levodopa therapy during the first 4 years from diagnosis in a cohort of de novo PD patients. The median time to introduction of L-dopa for patients with urinary symptoms was significantly shorter than that for those without (20 vs. 37 months; P = 0.001). Cox's regression models showed that the urinary domain was associated with a higher probability of starting L-dopa (hazard ratio: 2.1; P = 0.002). There was no influence of such confounders as sex, age, baseline motor features, use of dopamine agonists and/or monoamine oxidase B inhibitors, and total L-dopa equivalent daily dosage. Patients with urinary symptoms had higher baseline and follow-up motor and nonmotor disturbances than those without. Our study suggests the existence of a subgroup of patients who show urinary symptoms along with an overall higher motor and nonmotor burden. Such patients are prone to manifest a rapid functional decline over the first 4 years of the disease. Urinary symptoms might be a clinical marker of severity as well as a possible nonmotor subtype of PD.</div>
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<Title>Movement disorders : official journal of the Movement Disorder Society</Title>
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<Abstract><AbstractText>The variability in the clinical phenotype of Parkinson's disease (PD) suggests the existence of several subtypes of the disease. Motor heterogeneity of PD is well established, but not nonmotor heterogeneity. At present, we are unable to predict the rate of progression of PD based on robust biomarkers. We aimed to examine the heterogeneity of PD by attempting to identify nonmotor factors associated with the rate of motor progression and functional decline, as measured by the time to reach the need for levodopa therapy during the first 4 years from diagnosis in a cohort of de novo PD patients. The median time to introduction of L-dopa for patients with urinary symptoms was significantly shorter than that for those without (20 vs. 37 months; P = 0.001). Cox's regression models showed that the urinary domain was associated with a higher probability of starting L-dopa (hazard ratio: 2.1; P = 0.002). There was no influence of such confounders as sex, age, baseline motor features, use of dopamine agonists and/or monoamine oxidase B inhibitors, and total L-dopa equivalent daily dosage. Patients with urinary symptoms had higher baseline and follow-up motor and nonmotor disturbances than those without. Our study suggests the existence of a subgroup of patients who show urinary symptoms along with an overall higher motor and nonmotor burden. Such patients are prone to manifest a rapid functional decline over the first 4 years of the disease. Urinary symptoms might be a clinical marker of severity as well as a possible nonmotor subtype of PD.</AbstractText>
<CopyrightInformation>© 2015 International Parkinson and Movement Disorder Society.</CopyrightInformation>
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<CommentsCorrectionsList><CommentsCorrections RefType="CommentIn"><RefSource>Nat Rev Neurol. 2015 Mar;11(3):123</RefSource>
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<Keyword MajorTopicYN="N">early Parkinson's disease</Keyword>
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	Movement Disorders (revue)
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Movement Disorders (revue)

Nonmotor predictors for levodopa requirement in de novo patients with Parkinson's disease.

Nonmotor predictors for levodopa requirement in de novo patients with Parkinson's disease.

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Abstract

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