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

13 Citations (Scopus)
5 Downloads (Pure)

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

Keywords

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

Fingerprint Dive into the research topics of 'Variation in Recent Onset Parkinson's Disease: Implications for Prodromal Detection'. Together they form a unique fingerprint.

  • Cite this

    Swallow, D. M. A., Lawton, M. A., Grosset, K. A., Malek, N., Smith, C. R., Bajaj, N. P., Barker, R. A., Ben-Shlomo, Y., Burn, D. J., Foltynie, T., Hardy, J., Morris, H. R., Williams, N., Wood, N. W., Grosset, D. G., & 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