Nonmotor fluctuations in Parkinson's disease: Frequent and disabling
Identifieur interne : 003A23 ( Main/Merge ); précédent : 003A22; suivant : 003A24Nonmotor fluctuations in Parkinson's disease: Frequent and disabling
Auteurs : T. Witjas [France] ; E. Kaphan [France] ; J. P. Azulay [France] ; O. Blin [France] ; M. Ceccaldi [France] ; J. Pouget [France] ; M. Poncet [France] ; A. Ali Cherif [France]Source :
- Neurology [ 0028-3878 ] ; 2002.
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- Pascal (Inist)
- Wicri :
- topic : Homme.
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Abstract
Objective: To assess the frequency and disability caused by nonmotor fluctuations (NMF) in PD. Methods: A structured questionnaire was administered to 50 patients with PD with motor fluctuations (MF), focused on 54 nonmotor symptoms classified in three subgroups: 26 dysautonomic, 21 cognitive and psychiatric, and seven pain/sensory NMF. The link between each NMF and the motor state was determined. Patients were asked to grade their disability from 0 (no disability) to 4 (maximum discomfort) and to specify which kind of fluctuation subgroup (motor or nonmotor) was the most incapacitating. A statistical analysis was performed to determine the frequency of each NMF and to determine whether the level of disability resulting from NMF could be correlated to the main characteristics of the population. Results: All patients had had at least one type of NMF, most of which were associated with the "off" state. Anxiety (66%), drenching sweats (64%), slowness of thinking (58%), fatigue (56%), and akathisia (54%) were the most frequent NMF. Some symptoms such as anxiety or dyspnea correlated with a greater level of disability. The total number of NMF was found to be correlated with the motor disability. Incapacity resulting from the dysautonomic fluctuations was also significantly correlated with levodopa treatment. Surprisingly, 28% of the patients stated that NMF involved a greater degree of disability than MF. Conclusion: Nonmotor fluctuations are frequent and debilitating in PD.
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Witjas</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Neurology, CHU Timone</s1><s2>Marseille</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Provence-Alpes-Côte d'Azur</region><region type="old region">Provence-Alpes-Côte d'Azur</region><settlement type="city">Marseille</settlement></placeName></affiliation></author><author><name sortKey="Kaphan, E" sort="Kaphan, E" uniqKey="Kaphan E" first="E." last="Kaphan">E. Kaphan</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Neurology, CHU Timone</s1><s2>Marseille</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Provence-Alpes-Côte d'Azur</region><region type="old region">Provence-Alpes-Côte d'Azur</region><settlement type="city">Marseille</settlement></placeName></affiliation></author><author><name sortKey="Azulay, J P" sort="Azulay, J P" uniqKey="Azulay J" first="J. P." last="Azulay">J. P. Azulay</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Neurology, CHU Timone</s1><s2>Marseille</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Provence-Alpes-Côte d'Azur</region><region type="old region">Provence-Alpes-Côte d'Azur</region><settlement type="city">Marseille</settlement></placeName></affiliation></author><author><name sortKey="Blin, O" sort="Blin, O" uniqKey="Blin O" first="O." last="Blin">O. Blin</name><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>CPCET, CHU Timone</s1><s2>Marseille</s2><s3>FRA</s3><sZ>4 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Provence-Alpes-Côte d'Azur</region><region type="old region">Provence-Alpes-Côte d'Azur</region><settlement type="city">Marseille</settlement></placeName></affiliation></author><author><name sortKey="Ceccaldi, M" sort="Ceccaldi, M" uniqKey="Ceccaldi M" first="M." last="Ceccaldi">M. Ceccaldi</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Neurology, CHU Timone</s1><s2>Marseille</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Provence-Alpes-Côte d'Azur</region><region type="old region">Provence-Alpes-Côte d'Azur</region><settlement type="city">Marseille</settlement></placeName></affiliation></author><author><name sortKey="Pouget, J" sort="Pouget, J" uniqKey="Pouget J" first="J." last="Pouget">J. Pouget</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Neurology, CHU Timone</s1><s2>Marseille</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Provence-Alpes-Côte d'Azur</region><region type="old region">Provence-Alpes-Côte d'Azur</region><settlement type="city">Marseille</settlement></placeName></affiliation></author><author><name sortKey="Poncet, M" sort="Poncet, M" uniqKey="Poncet M" first="M." last="Poncet">M. Poncet</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Neurology, CHU Timone</s1><s2>Marseille</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Provence-Alpes-Côte d'Azur</region><region type="old region">Provence-Alpes-Côte d'Azur</region><settlement type="city">Marseille</settlement></placeName></affiliation></author><author><name sortKey="Ali Cherif, A" sort="Ali Cherif, A" uniqKey="Ali Cherif A" first="A." last="Ali Cherif">A. Ali Cherif</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Neurology, CHU Timone</s1><s2>Marseille</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Provence-Alpes-Côte d'Azur</region><region type="old region">Provence-Alpes-Côte d'Azur</region><settlement type="city">Marseille</settlement></placeName></affiliation></author></analytic><series><title level="j" type="main">Neurology</title><title level="j" type="abbreviated">Neurology</title><idno type="ISSN">0028-3878</idno><imprint><date when="2002">2002</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Neurology</title><title level="j" type="abbreviated">Neurology</title><idno type="ISSN">0028-3878</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Fluctuations</term><term>Frequency</term><term>Handicap</term><term>Human</term><term>Parkinson disease</term><term>Questionnaire</term><term>Symptomatology</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Parkinson maladie</term><term>Fluctuation</term><term>Handicap</term><term>Symptomatologie</term><term>Fréquence</term><term>Homme</term><term>Questionnaire</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Homme</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Objective: To assess the frequency and disability caused by nonmotor fluctuations (NMF) in PD. Methods: A structured questionnaire was administered to 50 patients with PD with motor fluctuations (MF), focused on 54 nonmotor symptoms classified in three subgroups: 26 dysautonomic, 21 cognitive and psychiatric, and seven pain/sensory NMF. The link between each NMF and the motor state was determined. Patients were asked to grade their disability from 0 (no disability) to 4 (maximum discomfort) and to specify which kind of fluctuation subgroup (motor or nonmotor) was the most incapacitating. A statistical analysis was performed to determine the frequency of each NMF and to determine whether the level of disability resulting from NMF could be correlated to the main characteristics of the population. Results: All patients had had at least one type of NMF, most of which were associated with the "off" state. Anxiety (66%), drenching sweats (64%), slowness of thinking (58%), fatigue (56%), and akathisia (54%) were the most frequent NMF. Some symptoms such as anxiety or dyspnea correlated with a greater level of disability. The total number of NMF was found to be correlated with the motor disability. Incapacity resulting from the dysautonomic fluctuations was also significantly correlated with levodopa treatment. Surprisingly, 28% of the patients stated that NMF involved a greater degree of disability than MF. Conclusion: Nonmotor fluctuations are frequent and debilitating in PD.</div></front></TEI><affiliations><list><country><li>France</li></country><region><li>Provence-Alpes-Côte d'Azur</li></region><settlement><li>Marseille</li></settlement></list><tree><country name="France"><region name="Provence-Alpes-Côte d'Azur"><name sortKey="Witjas, T" sort="Witjas, T" uniqKey="Witjas T" first="T." last="Witjas">T. Witjas</name></region><name sortKey="Ali Cherif, A" sort="Ali Cherif, A" uniqKey="Ali Cherif A" first="A." last="Ali Cherif">A. Ali Cherif</name><name sortKey="Azulay, J P" sort="Azulay, J P" uniqKey="Azulay J" first="J. P." last="Azulay">J. P. Azulay</name><name sortKey="Blin, O" sort="Blin, O" uniqKey="Blin O" first="O." last="Blin">O. Blin</name><name sortKey="Ceccaldi, M" sort="Ceccaldi, M" uniqKey="Ceccaldi M" first="M." last="Ceccaldi">M. Ceccaldi</name><name sortKey="Kaphan, E" sort="Kaphan, E" uniqKey="Kaphan E" first="E." last="Kaphan">E. Kaphan</name><name sortKey="Poncet, M" sort="Poncet, M" uniqKey="Poncet M" first="M." last="Poncet">M. Poncet</name><name sortKey="Pouget, J" sort="Pouget, J" uniqKey="Pouget J" first="J." last="Pouget">J. Pouget</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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