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Dopaminergic effect on non-motor symptoms in late stage Parkinson's disease

Rosqvist, Kristina LU ; Odin, Per LU orcid ; Hagell, Peter LU ; Iwarsson, Susanne LU ; Nilsson, Maria H. LU orcid and Storch, Alexander (2018) In Journal of Parkinson's Disease 8(3). p.409-420
Abstract

Background: Non-motor symptoms (NMS) are common in late stage Parkinson's disease (PD), as the frequency and severity of most of these symptoms increase with advancing disease. Objective: To assess effect of dopaminergic therapy on NMS in late stage PD and to investigate relationships between dopaminergic effect on NMS and on motor function. Method: Thirty PD patients in Hoehn and Yahr (HY) stages IV and V in "on" were included. Dopaminergic effect on non-motor symptomatology was assessed by the modified version of the Non-Motor Symptoms Scale (NMSS) in the "off" and the "on" state during a standardized L-dopa test, in parallel also assessing motor function. Results: NMS were common and many of the symptoms occurred in>80% of the... (More)

Background: Non-motor symptoms (NMS) are common in late stage Parkinson's disease (PD), as the frequency and severity of most of these symptoms increase with advancing disease. Objective: To assess effect of dopaminergic therapy on NMS in late stage PD and to investigate relationships between dopaminergic effect on NMS and on motor function. Method: Thirty PD patients in Hoehn and Yahr (HY) stages IV and V in "on" were included. Dopaminergic effect on non-motor symptomatology was assessed by the modified version of the Non-Motor Symptoms Scale (NMSS) in the "off" and the "on" state during a standardized L-dopa test, in parallel also assessing motor function. Results: NMS were common and many of the symptoms occurred in>80% of the individuals. The highest NMSS scores were seen within the NMSS domains 3: mood/apathy and 7: urinary in both the "off" and the "on" state. There was a statistically significant (p<0.001) improvement in the modified NMSS total score (median) from 79 in "off" to 64 in "on". There were statistically significant differences between the "off" and the "on" state for domains 2: sleep/fatigue, 3: mood/apathy, 5: attention/memory, 6: gastrointestinal and 7: urinary. The differences in the NMSS score between the "off" and the "on" state were in general larger for motor responders than for motor non-responders. In motor non-responders, differences of the NMSS score between the "off" and the "on" state were found for the total score, domain 3: mood/apathy and its item 11-flat moods. Conclusion: There is an effect of dopaminergic medication on NMS in late stage PD, to some extent also for those with a non-significant response on motor function during L-dopa test. It is therefore of importance to optimize dopaminergic therapy in order to give the most effective symptomatic treatment possible.

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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
apathy, fatigue, fluctuations, late stage, levodopa, levodopa test, mood, non-motor symptoms, Parkinson's disease, sleep
in
Journal of Parkinson's Disease
volume
8
issue
3
pages
12 pages
publisher
IOS Press
external identifiers
  • pmid:30056433
  • scopus:85051855418
ISSN
1877-7171
DOI
10.3233/JPD-181380
language
English
LU publication?
yes
id
3783f522-3edd-45e0-ae45-bfa61c860ef1
date added to LUP
2018-09-12 14:34:57
date last changed
2024-02-14 01:36:41
@article{3783f522-3edd-45e0-ae45-bfa61c860ef1,
  abstract     = {{<p>Background: Non-motor symptoms (NMS) are common in late stage Parkinson's disease (PD), as the frequency and severity of most of these symptoms increase with advancing disease. Objective: To assess effect of dopaminergic therapy on NMS in late stage PD and to investigate relationships between dopaminergic effect on NMS and on motor function. Method: Thirty PD patients in Hoehn and Yahr (HY) stages IV and V in "on" were included. Dopaminergic effect on non-motor symptomatology was assessed by the modified version of the Non-Motor Symptoms Scale (NMSS) in the "off" and the "on" state during a standardized L-dopa test, in parallel also assessing motor function. Results: NMS were common and many of the symptoms occurred in&gt;80% of the individuals. The highest NMSS scores were seen within the NMSS domains 3: mood/apathy and 7: urinary in both the "off" and the "on" state. There was a statistically significant (p&lt;0.001) improvement in the modified NMSS total score (median) from 79 in "off" to 64 in "on". There were statistically significant differences between the "off" and the "on" state for domains 2: sleep/fatigue, 3: mood/apathy, 5: attention/memory, 6: gastrointestinal and 7: urinary. The differences in the NMSS score between the "off" and the "on" state were in general larger for motor responders than for motor non-responders. In motor non-responders, differences of the NMSS score between the "off" and the "on" state were found for the total score, domain 3: mood/apathy and its item 11-flat moods. Conclusion: There is an effect of dopaminergic medication on NMS in late stage PD, to some extent also for those with a non-significant response on motor function during L-dopa test. It is therefore of importance to optimize dopaminergic therapy in order to give the most effective symptomatic treatment possible.</p>}},
  author       = {{Rosqvist, Kristina and Odin, Per and Hagell, Peter and Iwarsson, Susanne and Nilsson, Maria H. and Storch, Alexander}},
  issn         = {{1877-7171}},
  keywords     = {{apathy; fatigue; fluctuations; late stage; levodopa; levodopa test; mood; non-motor symptoms; Parkinson's disease; sleep}},
  language     = {{eng}},
  month        = {{07}},
  number       = {{3}},
  pages        = {{409--420}},
  publisher    = {{IOS Press}},
  series       = {{Journal of Parkinson's Disease}},
  title        = {{Dopaminergic effect on non-motor symptoms in late stage Parkinson's disease}},
  url          = {{http://dx.doi.org/10.3233/JPD-181380}},
  doi          = {{10.3233/JPD-181380}},
  volume       = {{8}},
  year         = {{2018}},
}