Non-motor symptoms of Parkinson’s Disease and their impact on quality of life in a cohort of Moroccan patients
Front. Neurol.. 2018-04-04; 9:
DOI: 10.3389/fneur.2018.00170
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Tibar H(1)(2)(3)(4), El Bayad K(2), Bouhouche A(1)(2), Ait Ben Haddou EH(1)(2),
Benomar A(1)(2), Yahyaoui M(1)(2), Benazzouz A(3)(4), Regragui W(1)(2).
Author information:
(1)Research Team in Neurology and Neurogenetics, Faculty of Medicine and
Pharmacy, Genomics Center of Human Pathologies, University Mohammed V, Rabat,
Morocco.
(2)Department of Neurology and Neurogenetics, Hôpital des spécialités de Rabat,
Rabat, Morocco.
(3)University de Bordeaux, Institut des maladies neurodégénératives, UMR 5293,
Bordeaux, France.
(4)CNRS, Institut des maladies neurodégénératives, UMR 5293, Bordeaux, France.
BACKGROUND: Non-motor symptoms (NMSs) are a real burden in Parkinson’s disease
(PD). They may appear in early pre-symptomatic stage as well as throughout the
disease course. However, their relationship with the deterioration of the
patient’s quality of life (QoL) is still under debate. This study aimed to
investigate the prevalence of NMSs and their impact on the QoL in a cohort of
Moroccan patients.
METHODS: We carried out a cross-transactional study, where a total of 117
patients were submitted to a structured clinical interview and examination
investigating motor and NMSs based on common and conventional scales. Motor
symptoms were assessed by the UPDRS I-VI during ON condition. The NMSs were
evaluated with common scales and their relationship with the QoL was
investigated.
RESULTS: The mean patient’s age was 60.77 ± 11.36 years old, and the median
disease duration was 6 years [2.5-9.5]. Motor’s phenotype subtypes were the
mixed form in 40.2% of patients, akinetic-rigid in 20.5% and a tremor-dominant
form in 39.3%. The median Hoehn and Yahr staging was 2 [1-2.5]. Regarding NMSs,
the most common were urinary dysfunctions (82.6%), sleep (80.6%), and
gastrointestinal (80%) disorders. Other autonomic dysfunctions were also
frequent: thermoregulatory dysfunctions 58.6%, cardiovascular troubles 50.9%,
and sexual dysfunctions 47.9%. Depression was present in 47.9% and fatigue
symptoms in 23.1%. The median score of SCOPA-AUT was 14 [7.75-21.80]. The median
PD questionnaire 39-score index (PDQ39-SI) was 23.22% and the most affected
dimension was « mobility. » Univariate and multivariate analyses showed that the
SCOPA-AUT score impacted the QoL (p = 0.001), especially the gastrointestinal
(p = 0.007), and cardiovascular (p = 0.049) dimensions.
CONCLUSION: Our data show that all patients have presented at least one NMS.
Autonomic and sleep disorders were the most frequent, and in contrast to other
studies, digestive and cardiovascular disorders were rather the factors
influencing negatively the QoL of patients. Understanding the pathophysiology of
these NMSs should be placed at the forefront in order to develop new therapeutic
approaches by improving the QoL of PD patients.