Inverstigation Of Non-motor Syptoms Of First-degree Relatives Of Patients With Parkinson's Disease

Part ? Investigation of the incidences of non-motor syrmptoms in first-degree relatives and the spouses of patients with Parkinson's diseaseObjective:Non-motor symptoms(NMS)are important prodromal characteristics of Parkinson's disease(PD),which appear before the onset of motor symptoms mostly.The first-degree relatives of PD patients(such as siblings)and the spouses living together for many years do not have classic motor symptoms.However,the incidence of NMS in first-degree relatives and spouses of PD patients is still unknown.Methods:A total of 98 PD patients of the Affiliated Hospital of Yangzhou University were recruited between January 2015 and August 2017;256 siblings of these patients were included in a first-degree relatives(FDR)group,87 spouses of PD patients were included in a spouses group and 250 healthy individuals were included in a control group.Record the general information for all the subjects.Various scales were used to assess NMS,including depression,anxiety,cognitive function,sleep status,constipation,daytime sleepiness,subjective olfactory disorder,Rapid-Eye-Movement Sleep Behavior Disorder(RBD),and Restless Legs Syndrome(RLS).Results:NMS were more common in the PD group than the control group.The incidence of anxiety(OR=3.06,95%CI:1.86-5.05,P<0.001),depression(OR=2.16,95%CI:1.16-4.04,P=0.01),RBD(OR=3.83,95%CI:1.79-8.19,P<0.001)and subjective olfactory disorder(OR=4.48,95%CI:2.02-9.90,P<0.001)was higher in the FDR group than the control group.There were non-significant differences in constipation,cognitive impairment,sleep disorder,daytime sleepiness,and RLS between the two groups.There were non-significant differences in NMS between the spouse group and control group,except the mild depression(OR=2.58,95%CI:1.07-6.20,P=0.03)in spouse groupwas more obvious.Conclusions:the first-degree relatives of PD are more likely to have PD prodromal symptoms compare with those without PD family history.It is speculated that PD patients and their siblings have common pathogenic genetic factors and early living environment for neurodegeneration.There is no obvious NMS in the spouses of PD.It can be concluded that the onset of PD is not related to the family life environment in adulthood.Part ? Differences of non-motor symptoms among first degree relatives with different clinical types of Parkinson's diseaseBackground:Non-motor symptoms(NMS)are important prodromal characteristics of Parkinson's disease(PD).The first-degree relatives(FDR)of PD patients had a higher risk of PD,and also had more NMS.Objective:To investigate the difference in NMS in FDR of patients with different clinical types of PD.Methods:A total of 98 PD probands were recruited for the study;256 siblings with PD were enrolled in the FDR group.Various scales were used to assessNMS,including depression,anxiety,cognitive impairment,insomnia,constipation,excessive daytime sleepiness(EDS),rapid-eye-movement sleep behavior disorder(RBD),and restless legs syndrome(RLS).The incidences of NMS were further compared among the FDR of PD with different types.Results:The FDR of patients with early-onset PD(EOP)showed a higher incidence of moderate to severe depression(OR=4.50;95%CI:1.32-15.33;P=0.02)and anxiety(OR=8.00;95%CI:2.46-26.02;P<0.001)than the FDR of late-onset PD(LOP).The FDR of EOP appeared to have a higher frequency of excessive daytime sleepiness,although without statistical significance(OR=3.19;95%CI:1.00-10.19;P=0.05).It was also found that RBD(OR=5.71,95%CI:2.23-14.60;P<0.001),constipation(OR=4.93;95%CI:1.81-13.12;P<0.001),sleep disorders(OR=3.73;95%CI:1.53-9.11,P=0.004),cognitive impairment(ORF;3.21;95%CI:1.55-6.67;P=0.002)and anxiety(OR=2.02;95%CI:1.12-3.66;P=0.02)were more frequent in FDR of tremor dominant PD(TDP)than in FDR of nontremor dominant PD(NTDP).Conclusions:The FDR of patients with EOP and the FDR of patients with TDP mayhave more NMS,presuming that they have a higher risk in the PD prodromal stage.Whether these FDR have a greater possibility to progress into PD requires further investigation.