Variation in Recent Onset Parkinson's Disease

Implications for Prodromal Detection

Diane M. A. Swallow (Corresponding Author), Michael A Lawton, Katherine A. Grosset, Naveed Malek, Callum R. Smith, Nin P. Bajaj, Roger A. Barker, Yoav Ben-Shlomo, David J. Burn, Thomas Foltynie, John Hardy, Huw R. Morris, Nigel Williams, Nicholas W. Wood, Donald G. Grosset, PRoBaND Clinical Consortium

Research output: Contribution to journalArticle

9 Citations (Scopus)
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Abstract

BACKGROUND: The detection of prodromal Parkinson's disease (PD) is desirable to test drugs with neuroprotective potential, but will be affected by known disease variations.

OBJECTIVE: To assess the prevalence of four key non-motor prodromal PD markers, and evaluate the sensitivity of case detection when non-motor screening tools for prodromal PD are implemented in an early clinical PD cohort.

METHODS: Hyposmia (University of Pennsylvania smell identification test ≤15th centile or Sniffin' Sticks at or ≤10th centile corrected for age and sex), rapid-eye movement sleep behaviour disorder (RBD questionnaire >4), constipation (<1 daily spontaneous bowel motion) and depression (Leeds >6) were recorded in recent onset PD cases, and proposed non-motor screening criteria applied.

RESULTS: In 1,719 PD cases, mean age 68.6 years (SD 8.1), 65.5% male, mean disease duration 1.3 years (SD 0.9), 72.2% were hyposmic, 43.3% had RBD, 22.1% depression, and 21.5% constipation. 11.6% of cases had no key non-motor features, 38.8% one, 32.1% two, 15.5% three, and 2.0% all four. Increasing numbers of non-motor features were associated with younger age (p = 0.019), higher motor scores (p < 0.001), more postural instability gait difficulty (PIGD) (p < 0.001), greater cognitive impairment (p < 0.001) and higher total non-motor burden (p < 0.001). Cases with hyposmia alone were younger (p < 0.001), had less severe cognitive (p = 0.006) and other non-motor features (p < 0.001). All screening criteria selected younger patients (p = 0.001, p < 0.001), three of four greater overall non-motor burden (p = 0.005, p < 0.001), and inclusion of RBD more cognitive impairment (p = 0.003, p = 0.001) and PIGD (p = 0.004, p = 0.001).

CONCLUSIONS: Varying sensitivity levels, and age and phenotype selectivity, are found when different non-motor screening methods to detect prodromal PD are applied to an early clinical PD cohort.

Original languageEnglish
Pages (from-to)289-300
Number of pages12
Journal Journal of Parkinson's Disease
Volume6
Issue number2
DOIs
Publication statusPublished - 26 May 2016

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Parkinson Disease
Constipation
Gait
REM Sleep Behavior Disorder
Smell
Neuroprotective Agents
Depression
Phenotype

Keywords

  • Parkinson disease
  • anosmia
  • rapid eye movement sleep behavior disorder
  • depression
  • constipation

Cite this

Swallow, D. M. A., Lawton, M. A., Grosset, K. A., Malek, N., Smith, C. R., Bajaj, N. P., ... PRoBaND Clinical Consortium (2016). Variation in Recent Onset Parkinson's Disease: Implications for Prodromal Detection. Journal of Parkinson's Disease, 6(2), 289-300. https://doi.org/10.3233/JPD-150741

Variation in Recent Onset Parkinson's Disease : Implications for Prodromal Detection. / Swallow, Diane M. A. (Corresponding Author); Lawton, Michael A; Grosset, Katherine A.; Malek, Naveed; Smith, Callum R.; Bajaj, Nin P.; Barker, Roger A.; Ben-Shlomo, Yoav; Burn, David J.; Foltynie, Thomas; Hardy, John; Morris, Huw R.; Williams, Nigel; Wood, Nicholas W.; Grosset, Donald G.; PRoBaND Clinical Consortium.

In: Journal of Parkinson's Disease, Vol. 6, No. 2, 26.05.2016, p. 289-300.

Research output: Contribution to journalArticle

Swallow, DMA, Lawton, MA, Grosset, KA, Malek, N, Smith, CR, Bajaj, NP, Barker, RA, Ben-Shlomo, Y, Burn, DJ, Foltynie, T, Hardy, J, Morris, HR, Williams, N, Wood, NW, Grosset, DG & PRoBaND Clinical Consortium 2016, 'Variation in Recent Onset Parkinson's Disease: Implications for Prodromal Detection', Journal of Parkinson's Disease, vol. 6, no. 2, pp. 289-300. https://doi.org/10.3233/JPD-150741
Swallow, Diane M. A. ; Lawton, Michael A ; Grosset, Katherine A. ; Malek, Naveed ; Smith, Callum R. ; Bajaj, Nin P. ; Barker, Roger A. ; Ben-Shlomo, Yoav ; Burn, David J. ; Foltynie, Thomas ; Hardy, John ; Morris, Huw R. ; Williams, Nigel ; Wood, Nicholas W. ; Grosset, Donald G. ; PRoBaND Clinical Consortium. / Variation in Recent Onset Parkinson's Disease : Implications for Prodromal Detection. In: Journal of Parkinson's Disease. 2016 ; Vol. 6, No. 2. pp. 289-300.
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abstract = "BACKGROUND: The detection of prodromal Parkinson's disease (PD) is desirable to test drugs with neuroprotective potential, but will be affected by known disease variations.OBJECTIVE: To assess the prevalence of four key non-motor prodromal PD markers, and evaluate the sensitivity of case detection when non-motor screening tools for prodromal PD are implemented in an early clinical PD cohort.METHODS: Hyposmia (University of Pennsylvania smell identification test ≤15th centile or Sniffin' Sticks at or ≤10th centile corrected for age and sex), rapid-eye movement sleep behaviour disorder (RBD questionnaire >4), constipation (<1 daily spontaneous bowel motion) and depression (Leeds >6) were recorded in recent onset PD cases, and proposed non-motor screening criteria applied.RESULTS: In 1,719 PD cases, mean age 68.6 years (SD 8.1), 65.5{\%} male, mean disease duration 1.3 years (SD 0.9), 72.2{\%} were hyposmic, 43.3{\%} had RBD, 22.1{\%} depression, and 21.5{\%} constipation. 11.6{\%} of cases had no key non-motor features, 38.8{\%} one, 32.1{\%} two, 15.5{\%} three, and 2.0{\%} all four. Increasing numbers of non-motor features were associated with younger age (p = 0.019), higher motor scores (p < 0.001), more postural instability gait difficulty (PIGD) (p < 0.001), greater cognitive impairment (p < 0.001) and higher total non-motor burden (p < 0.001). Cases with hyposmia alone were younger (p < 0.001), had less severe cognitive (p = 0.006) and other non-motor features (p < 0.001). All screening criteria selected younger patients (p = 0.001, p < 0.001), three of four greater overall non-motor burden (p = 0.005, p < 0.001), and inclusion of RBD more cognitive impairment (p = 0.003, p = 0.001) and PIGD (p = 0.004, p = 0.001).CONCLUSIONS: Varying sensitivity levels, and age and phenotype selectivity, are found when different non-motor screening methods to detect prodromal PD are applied to an early clinical PD cohort.",
keywords = "Parkinson disease, anosmia, rapid eye movement sleep behavior disorder, depression, constipation",
author = "Swallow, {Diane M. A.} and Lawton, {Michael A} and Grosset, {Katherine A.} and Naveed Malek and Smith, {Callum R.} and Bajaj, {Nin P.} and Barker, {Roger A.} and Yoav Ben-Shlomo and Burn, {David J.} and Thomas Foltynie and John Hardy and Morris, {Huw R.} and Nigel Williams and Wood, {Nicholas W.} and Grosset, {Donald G.} and {PRoBaND Clinical Consortium}",
note = "The research was funded by Parkinson’s UK and supported by the National Institute for Health Research (NIHR) DeNDRoN network, the NIHR Newcastle Biomedical Research Unit based at Newcastle upon Tyne Hospitals NHS Foundation Trust and Newcastle University, and the NIHR funded Biomedical Research Centre in Cambridge.",
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day = "26",
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TY - JOUR

T1 - Variation in Recent Onset Parkinson's Disease

T2 - Implications for Prodromal Detection

AU - Swallow, Diane M. A.

AU - Lawton, Michael A

AU - Grosset, Katherine A.

AU - Malek, Naveed

AU - Smith, Callum R.

AU - Bajaj, Nin P.

AU - Barker, Roger A.

AU - Ben-Shlomo, Yoav

AU - Burn, David J.

AU - Foltynie, Thomas

AU - Hardy, John

AU - Morris, Huw R.

AU - Williams, Nigel

AU - Wood, Nicholas W.

AU - Grosset, Donald G.

AU - PRoBaND Clinical Consortium

N1 - The research was funded by Parkinson’s UK and supported by the National Institute for Health Research (NIHR) DeNDRoN network, the NIHR Newcastle Biomedical Research Unit based at Newcastle upon Tyne Hospitals NHS Foundation Trust and Newcastle University, and the NIHR funded Biomedical Research Centre in Cambridge.

PY - 2016/5/26

Y1 - 2016/5/26

N2 - BACKGROUND: The detection of prodromal Parkinson's disease (PD) is desirable to test drugs with neuroprotective potential, but will be affected by known disease variations.OBJECTIVE: To assess the prevalence of four key non-motor prodromal PD markers, and evaluate the sensitivity of case detection when non-motor screening tools for prodromal PD are implemented in an early clinical PD cohort.METHODS: Hyposmia (University of Pennsylvania smell identification test ≤15th centile or Sniffin' Sticks at or ≤10th centile corrected for age and sex), rapid-eye movement sleep behaviour disorder (RBD questionnaire >4), constipation (<1 daily spontaneous bowel motion) and depression (Leeds >6) were recorded in recent onset PD cases, and proposed non-motor screening criteria applied.RESULTS: In 1,719 PD cases, mean age 68.6 years (SD 8.1), 65.5% male, mean disease duration 1.3 years (SD 0.9), 72.2% were hyposmic, 43.3% had RBD, 22.1% depression, and 21.5% constipation. 11.6% of cases had no key non-motor features, 38.8% one, 32.1% two, 15.5% three, and 2.0% all four. Increasing numbers of non-motor features were associated with younger age (p = 0.019), higher motor scores (p < 0.001), more postural instability gait difficulty (PIGD) (p < 0.001), greater cognitive impairment (p < 0.001) and higher total non-motor burden (p < 0.001). Cases with hyposmia alone were younger (p < 0.001), had less severe cognitive (p = 0.006) and other non-motor features (p < 0.001). All screening criteria selected younger patients (p = 0.001, p < 0.001), three of four greater overall non-motor burden (p = 0.005, p < 0.001), and inclusion of RBD more cognitive impairment (p = 0.003, p = 0.001) and PIGD (p = 0.004, p = 0.001).CONCLUSIONS: Varying sensitivity levels, and age and phenotype selectivity, are found when different non-motor screening methods to detect prodromal PD are applied to an early clinical PD cohort.

AB - BACKGROUND: The detection of prodromal Parkinson's disease (PD) is desirable to test drugs with neuroprotective potential, but will be affected by known disease variations.OBJECTIVE: To assess the prevalence of four key non-motor prodromal PD markers, and evaluate the sensitivity of case detection when non-motor screening tools for prodromal PD are implemented in an early clinical PD cohort.METHODS: Hyposmia (University of Pennsylvania smell identification test ≤15th centile or Sniffin' Sticks at or ≤10th centile corrected for age and sex), rapid-eye movement sleep behaviour disorder (RBD questionnaire >4), constipation (<1 daily spontaneous bowel motion) and depression (Leeds >6) were recorded in recent onset PD cases, and proposed non-motor screening criteria applied.RESULTS: In 1,719 PD cases, mean age 68.6 years (SD 8.1), 65.5% male, mean disease duration 1.3 years (SD 0.9), 72.2% were hyposmic, 43.3% had RBD, 22.1% depression, and 21.5% constipation. 11.6% of cases had no key non-motor features, 38.8% one, 32.1% two, 15.5% three, and 2.0% all four. Increasing numbers of non-motor features were associated with younger age (p = 0.019), higher motor scores (p < 0.001), more postural instability gait difficulty (PIGD) (p < 0.001), greater cognitive impairment (p < 0.001) and higher total non-motor burden (p < 0.001). Cases with hyposmia alone were younger (p < 0.001), had less severe cognitive (p = 0.006) and other non-motor features (p < 0.001). All screening criteria selected younger patients (p = 0.001, p < 0.001), three of four greater overall non-motor burden (p = 0.005, p < 0.001), and inclusion of RBD more cognitive impairment (p = 0.003, p = 0.001) and PIGD (p = 0.004, p = 0.001).CONCLUSIONS: Varying sensitivity levels, and age and phenotype selectivity, are found when different non-motor screening methods to detect prodromal PD are applied to an early clinical PD cohort.

KW - Parkinson disease

KW - anosmia

KW - rapid eye movement sleep behavior disorder

KW - depression

KW - constipation

U2 - 10.3233/JPD-150741

DO - 10.3233/JPD-150741

M3 - Article

VL - 6

SP - 289

EP - 300

JO - Journal of Parkinson's Disease

JF - Journal of Parkinson's Disease

SN - 1877-7171

IS - 2

ER -