The KMDS-NATION Study: Korean Movement Disorders Society Multicenter Assessment of Non-Motor Symptoms and Quality of Life in Parkinson's Disease NATION Study Group.
OBJECTIVE
Nonmotor symptoms (NMS) in Parkinson's disease (PD) have multisystem origins with heterogeneous manifestations that develop throughout the course of PD. NMS are increasingly recognized as having a significant impact on the health-related quality of life (HrQoL). We aimed to determine the NMS presentation according to PD status, and the associations of NMS with other clinical variables and the HrQoL of Korean PD patients.


METHODS
We surveyed patients in 37 movement-disorders clinics throughout Korea. In total, 323 PD patients were recruited for assessment of disease severity and duration, NMS, HrQoL, and other clinical variables including demographics, cognition, sleep scale, fatigability, and symptoms.


RESULTS
In total, 98.1% of enrolled PD subjects suffered from various kinds of NMS. The prevalence of NMS and scores in each NMS domain were significantly higher in the PD group, and the NMS worsened as the disease progressed. Among clinical variables, disease duration and depressive mood showed significant correlations with all NMS domains (p<0.001). NMS status impacted HrQoL in PD (rS=0.329, p<0.01), and the association patterns differed with the disease stage.


CONCLUSIONS
The results of our survey suggest that NMS in PD are not simply isolated symptoms of degenerative disease, but rather exert significant influences throughout the disease course. A novel clinical approach focused on NMS to develop tailored management strategies is warranted to improve the HrQoL in PD patients.
Department of Neurology, Korea University College of Medicine, Seoul, Korea.
Do Young
DY
Kwon
Department of Neurology, Korea University College of Medicine, Seoul, Korea.
Seong Beom
SB
Koh
Department of Neurology, Pusan National University Yangsan Hospital, Yangsan, Korea.
Jae Hyeok
JH
Lee
Department of Neurology, Inje University College of Medicine, Ilsan Paik Hospital, Goyang, Korea.
Hee Kyung
HK
Park
Department of Neurology, Seoul National University College of Medicine, Seoul, Korea.
Han Joon
HJ
Kim
Department of Neurology, Chung-Ang University College of Medicine, Seoul, Korea.
Hae Won
HW
Shin
Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Jinyoung
J
Youn
Department of Neurology, Korea University College of Medicine, Seoul, Korea.
Kun Woo
KW
Park
Department of Neurology, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea.
Sun Ah
SA
Choi
Department of Neurology, Inje University College of Medicine, Busan Paik Hospital, Busan, Korea.
Sang Jin
SJ
Kim
Department of Neurology, Chonnam National University Medical School, Gwangju, Korea.
Seong Min
SM
Choi
Department of Neurology, Presbyterian Medical Center, Jeonju, Korea.
Ji Yun
JY
Park
Department of Neurology, Seoul National University College of Medicine, Seoul, Korea.
Beom S
BS
Jeon
Department of Neurology, College of Medicine, Inje University Seoul Paik Hospital, Seoul, Korea.
Ji Young
JY
Kim
Department of Neurology, University of Ulsan College of Medicine, Asan Hospital, Seoul, Korea.
Sun Ju
SJ
Chung
Department of Neurology, University of Ulsan College of Medicine, Asan Hospital, Seoul, Korea.
Chong Sik
CS
Lee
Department of Neurology, College of Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea.
Jeong Ho
JH
Park
Department of Neurology, Kyung Hee University College of Medicine, Seoul, Korea.
Tae Beom
TB
Ahn
Department of Neurology, CHA University College of Medicine, Seongnam, Korea.
Won Chan
WC
Kim
Department of Neurology, CHA University College of Medicine, Seongnam, Korea.
Hyun Sook
HS
Kim
Department of Neurology, Dong-A University Medical Centre, Busan, Korea.
Sang Myung
SM
Cheon
Department of Neurology, College of Medicine, Hanyang University, Seoul, Korea.
Hee Tae
HT
Kim
Department of Neurology, Seoul National University Boramae Hospital, Seoul, Korea.
Jee Young
JY
Lee
Department of Neurology, College of Medicine, Chungbuk National University, Chungbuk National University Hospital, Daejeon, Korea.
Ji Sun
JS
Kim
Department of Neurology, Pusan National University School of Medicine and Medical Research Institute, Busan, Korea.
Eun Joo
EJ
Kim
Department of Neurology, Seoul National University Bundang Hospital, Seongnam, Korea.
Jong Min
JM
Kim
Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Kwang Soo
KS
Lee
Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Joong Seok
JS
Kim
Department of Neurology, Kosin University College of Medicine, Busan, Korea.
Min Jeong
MJ
Kim
Department of Neurology, College of Medicine, Inje University, Sanggye Paik Hospital, Seoul, Korea.
Jong Sam
JS
Baik
Department of Neurology, Gyeongsang National University School of Medicine, Busan, Korea.
Ki Jong
KJ
Park
Department of Neurology, Konkuk University School of Medicine, Daejeon, Korea.
Hee Jin
HJ
Kim
Department of Neurology, Yeungnam University College of Medicine, Daegu, Korea.
Mee Young
MY
Park
Department of Neurology, Jeju National University Hospital, Jeju, Korea.
Ji Hoon
JH
Kang
Department of Neurology, Jeju National University Hospital, Jeju, Korea.
Sook Kun
SK
Song
Department of Neurology, Konyang University Hospital, Daejeon, Korea.
Yong Duk
YD
Kim
Department of Neurology, Ewha Womans University Mokdong Hospital, Seoul, Korea.
Ji Young
JY
Yun
Department of Neurology, School of Medicine, Kyungpook National Univeristy, Daegu, Korea.
Ho Won
HW
Lee
Department of Neurology, College of Medicine, Soonchunhyang University, Cheonan, Korea.
Hyung Geun
HG
Oh
Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Jinwhan
J
Cho
Department of Neurology, College of Medicine, The Catholic University of Korea, Incheon, Korea.
In Uk
IU
Song
Department of Neurology, Yonsei University College of Medicine, Seoul, Korea.
Young H
YH
Sohn
Department of Neurology, Yonsei University College of Medicine, Seoul, Korea.
Phil Hyu
PH
Lee
Department of Neurology, Dong-A University Medical Centre, Busan, Korea. jwkim@dau.ac.kr.
Jae Woo
JW
Kim
Parkinson's disease; non-motor symptoms; quality of life