title: Clinical manifestations of nonmotor symptoms in 1021 Japanese Parkinson's disease patients from 35 medical centers.
abstract: BACKGROUND
  We aimed to investigate the prevalence and severity of nonmotor symptoms (NMSs) and to identify factors affecting NMSs and the health-related quality of life of Japanese patients with Parkinson's disease (PD).
  
  
  METHODS
  A total of 1021 patients with PD who had one or more NMS and showed wearing-off under anti-parkinsonian treatment were enrolled from 35 medical centers in Japan for this observational study. The primary measurements were the Movement Disorder Society unified Parkinson's disease rating scale (MDS-UPDRS) part I and the Parkinson's Disease Questionnaire (PDQ-8). The relationships of MDS-UPDRS and PDQ-8 with the patient's clinical background and undertaken medical interventions were determined. Here, we report baseline data of our 52-week ongoing study.
  
  
  RESULTS
  The mean MDS-UPDRS part I and PDQ-8 scores were 10.9 and 7.3, respectively. The most common NMSs were constipation problems (85.4%), sleep problems (73.7%), pain and other sensations (72.7%) and daytime sleepiness (72.0%). Fatigue was an NMS that affected 79.6% of females but only 72.6% of males, whereas features of dopamine dysregulation syndrome affected only 5.6% of females and 10.8% of males. Positive correlations were found between the MDS-UPDRS part I and the PDQ-8 (p < 0.0001, r = 0.56) and between the number of NMSs and the PDQ-8 score (p < 0.0001, r = 0.47).
  
  
  CONCLUSIONS
  This study revealed distinctive patterns of NMSs in Japanese patients with PD and suggested that the prevalence and severity of NMSs vary between sexes, and that the NMSs are important factors affecting the long-term quality of life of PD patients.
authors.affiliation: Division of Neurology and Gerontology, Department of Internal Medicine, School of Medicine, Iwate Medical University, 19-1 Uchimaru, Morioka, Iwate 020-8505, Japan; Department of Neurology and Movement Disorder Research, Research Institute for Brain and Blood Vessels-Akita, 6-10 Senshukubotamachi, Akita 010-0874, Japan. Electronic address: maeda@iwate-med.ac.jp.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Maeda
authors.affiliation: Department of Neurology, Juntendo University School of Medicine 3-1-3 Hongo, Bunkyo-ku, Tokyo 113-8431, Japan. Electronic address: yshimo@juntendo.ac.jp.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Shimo
authors.affiliation: Division of Biostatistics, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan. Electronic address: chiu@med.tohoku.ac.jp.
authors.forename: Shih-Wei
authors.initials: SW
authors.lastname: Chiu
authors.affiliation: Division of Biostatistics, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8575, Japan. Electronic address: yamaguchi@med.tohoku.ac.jp.
authors.forename: Takuhiro
authors.initials: T
authors.lastname: Yamaguchi
authors.affiliation: Department of Neurology, Okayama Kyokuto Hospital, 567-1 Kurata, Okayama, 703-8265, Japan. Electronic address: kkashi@kyokuto.or.jp.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Kashihara
authors.affiliation: Department of Neurology, Faculty of Medicine, Fukuoka University, 3-1-1, Maidashi, Higashi-ku, Fukuoka City, 812-8582, Japan. Electronic address: tsuboi@cis.fukuoka-u.ac.jp.
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Tsuboi
authors.affiliation: Department of Neurology and Clinical Pharmacology, Ehime University Graduate School of Medicine, 454 Shizukawa, Tohon, Ehime 791-0295, Japan. Electronic address: nomoto@m.ehime-u.ac.jp.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Nomoto
authors.affiliation: Department of Neurology, Juntendo University School of Medicine 3-1-3 Hongo, Bunkyo-ku, Tokyo 113-8431, Japan. Electronic address: nhattori@juntendo.ac.jp.
authors.forename: Nobutaka
authors.initials: N
authors.lastname: Hattori
authors.affiliation: Brain and Mind Research Center, Nagoya University, Furo-cho, Chikusa-ku, Nagoya 464-8602, Japan. Electronic address: nabe@med.nagoya-u.ac.jp.
authors.forename: Hirohisa
authors.initials: H
authors.lastname: Watanabe
authors.affiliation: Department of Neurology, Kitano Hospital, The Tazuke Kofukai Medical Research Institute, 2-4-20 Ohgimachi, Kita-ku, Osaka 530-8480, Japan. Electronic address: saiki@kuhp.kyoto-u.ac.jp.
authors.forename: Hidemoto
authors.initials: H
authors.lastname: Saiki
mesh_terms: D000368:Aged; D003248:Constipation / Q000209:etiology*; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology*; D010300:Parkinson Disease / Q000150:complications*; D011446:Prospective Studies; D012044:Regression Analysis; D012678:Sensation Disorders / Q000209:etiology*; D012720:Severity of Illness Index; D012737:Sex Factors; D012893:Sleep Wake Disorders / Q000209:etiology*; D011795:Surveys and Questionnaires
keywords: Japan; Nonmotor symptoms; Parkinson's disease; Quality of life