title: Delineating nonmotor symptoms in early Parkinson's disease and first-degree relatives.
abstract: Nonmotor symptoms (NMS) are an important prodromal feature of Parkinson's disease (PD). However, their frequency, treatment rates, and impact on health-related quality of life (HRQoL) in the early motor phase is unclear. Rates of NMS in enriched at-risk populations, such as first-degree PD relatives, have not been delineated. We assessed NMS in an early cohort of PD, first-degree PD relatives and control subjects to address these questions. In total, 769 population-ascertained PD subjects within 3.5 years of diagnosis, 98 first-degree PD relatives, and 287 control subjects were assessed at baseline across the following NMS domains: (1) neuropsychiatric; (2) gastrointestinal; (3) sleep; (4) sensory; (5) autonomic; and (6) sexual. NMS were much more common in PD, compared to control subjects. More than half of the PD cases had hyposmia, pain, fatigue, sleep disturbance, or urinary dysfunction. NMS were more frequent in those with the postural instability gait difficulty phenotype, compared to the tremor dominant (mean total number of NMS 7.8 vs. 6.2; P < 0.001). PD cases had worse HRQoL scores than controls (odds ratio: 4.1; P < 0.001), with depression, anxiety, and pain being stronger drivers than motor scores. NMS were rarely treated in routine clinical practice. First-degree PD relatives did not significantly differ in NMS, compared to controls, in this baseline study. NMS are common in early PD and more common in those with postural instability gait difficulty phenotype or on treatment. Despite their major impact on quality of life, NMS are usually under-recognized and untreated.
authors.affiliation: Oxford Parkinson's Disease Centre, University of Oxford, Oxford, United Kingdom.|Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom.
authors.forename: Fahd
authors.initials: F
authors.lastname: Baig
authors.affiliation: School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom.
authors.forename: Michael
authors.initials: M
authors.lastname: Lawton
authors.affiliation: Oxford Parkinson's Disease Centre, University of Oxford, Oxford, United Kingdom.|Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom.
authors.forename: Michal
authors.initials: M
authors.lastname: Rolinski
authors.affiliation: Oxford Parkinson's Disease Centre, University of Oxford, Oxford, United Kingdom.|Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom.
authors.forename: Claudio
authors.initials: C
authors.lastname: Ruffmann
authors.affiliation: Oxford Parkinson's Disease Centre, University of Oxford, Oxford, United Kingdom.|Department of Neurology, Northampton General Hospital NHS Trust, Northampton, United Kingdom.
authors.forename: Kannan
authors.initials: K
authors.lastname: Nithi
authors.affiliation: Oxford Parkinson's Disease Centre, University of Oxford, Oxford, United Kingdom.|Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom.
authors.forename: Samuel G
authors.initials: SG
authors.lastname: Evetts
authors.affiliation: Oxford Parkinson's Disease Centre, University of Oxford, Oxford, United Kingdom.
authors.forename: Hugo R
authors.initials: HR
authors.lastname: Fernandes
authors.affiliation: Oxford Parkinson's Disease Centre, University of Oxford, Oxford, United Kingdom.|School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom.
authors.forename: Yoav
authors.initials: Y
authors.lastname: Ben-Shlomo
authors.affiliation: Oxford Parkinson's Disease Centre, University of Oxford, Oxford, United Kingdom.|Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom.
authors.forename: Michele T M
authors.initials: MT
authors.lastname: Hu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001342:Autonomic Nervous System Diseases / Q000209:etiology; D003072:Cognition Disorders / Q000209:etiology; D003863:Depression / Q000209:etiology*; D005190:Family; D005260:Female; D006801:Humans; D000071158:Leucine-Rich Repeat Serine-Threonine Protein Kinase-2; D008297:Male; D001523:Mental Disorders / Q000209:etiology*; D008875:Middle Aged; D009154:Mutation / Q000235:genetics; D000857:Olfaction Disorders / Q000209:etiology; D010300:Parkinson Disease / Q000150:complications* / Q000235:genetics* / Q000523:psychology; D017346:Protein Serine-Threonine Kinases / Q000235:genetics; D011788:Quality of Life; D012893:Sleep Wake Disorders / Q000209:etiology*; D011795:Surveys and Questionnaires; D001617:beta-Glucosidase / Q000235:genetics
chemical_list: C495280:LRRK2 protein, human; D000071158:Leucine-Rich Repeat Serine-Threonine Protein Kinase-2; D017346:Protein Serine-Threonine Kinases; D001617:beta-Glucosidase
keywords: Parkinson's disease; first-degree relatives; nonmotor symptoms; quality of life; treatment