Dopaminergic effect on non-motor symptoms in late stage Parkinson's disease
(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
- Rosqvist, Kristina LU ; Odin, Per LU ; Hagell, Peter LU ; Iwarsson, Susanne LU ; Nilsson, Maria H. LU and Storch, Alexander
- organization
- publishing date
- 2018-07-05
- 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
- pmid:30056433
- 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
- 2024-06-10 17:17:22
@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>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.</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}}, }