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

Rosqvist, Kristina LU ; Odin, Per LU ; Hagell, Peter LU ; Iwarsson, Susanne LU ; Nilsson, Maria H. LU 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
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
  • 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
2019-05-21 04:11:02
@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},
  keyword      = {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},
  volume       = {8},
  year         = {2018},
}