Study On Clinical Characteristics Of Non-motor Symptoms In Parkinson's Disease Patients

ObjectiveParkinson's disease(PD)is the second most common neurodegenerative disease after Alzheimer's disease(AD).PD is characterized by four major motor symptoms: limb tremor,muscle rigidity,bradykinesia and posture gait disturbance.With the development of research,it is found that in addition to these typical dopaminergic motor symptoms,non-motor symptoms(NMS)such as neuropsychiatric symptoms,sensory symptoms,sleep disturbances,autonomic nervous function disorder,etc.have brought more serious impact on patients and greatly reduced their quality of life.With its latent and extensive nature gradually highlighted,the diagnosis and treatment of NMS has attracted more and more attention.In view of this,72 patients with PD were studied retrospectively in order to explore the incidence of NMS,the correlation and influencing factors between NMS and general conditions(age,gender,duration of disease,educational level),motor symptoms,and the incidence and related factors of depression,anxiety,sleep and cognitive dysfunction in PD patients.Methods1.72 patients with PD who were hospitalized in the General Hospital of Ningxia Medical University from December 2016 to December 2018 were collected.All of them met the Chinese Parkinson's Disease Diagnostic Standard(The 2016 Edition)of the Parkinson'sDisease and Dyskinesia Group of the Neurological Society of the Chinese Medical Association.2.With the informed consent of patients and their families,the general information of patients(gender,age,educational level,duration of disease,family history,combined with basic diseases,medication status,etc.)and the medical history of patients were recorded and the physical examination of nervous system was completed.3.To complete the scale evaluation,motor symptoms were used: Unified Parkinson's Disease Rating Scale Part III(UPDRS-III),modified Hoehn-Yahr(H-Y)rating scale.Non-motor symptoms were used: Non-Motor Symptoms Questionnaire(NMSQuest),Hamilton Anxiety Scale(HAMA),Hamilton Depression Scale(HAMD),Pittsburgh Sleep Quality Index(PSQI),and Fatigue Scale-14(FS-14),Montreal Cognitive Assessment(MoCA).4.SPSS 19.0 statistical software was used for data processing and analysis:(1)the incidence of each NMS in patients with PD;(2)NMS and NMS occurrences related to age,gender,duration of disease,educational level,modified H-Y rating and motor rating;(3)the incidence of depression,anxiety,sleep and cognitive dysfunction in patients with PD and related factors.Results1.72 patients with PD had at least one NMS,and the incidence of NMS was 100%.Among all kinds of NMS,the incidence of constipation was the highest(72.2%),followed by memory loss(70.8%),sadness,depression(68.1%),restless legs(68.1%),etc.2.The incidence of nausea,vomiting,incomplete defecation,multiple dreams or nightmares increased with the increase of duration of disease,which was statistically significant.The incidence of nausea and vomiting increased with the increase of educational level,which was statistically significant.Male patients were prone to constipation,increased nocturia,which was statistically significant.The incidence of daytime sleepiness was higherin the stiff-retarded type than in the mixed type.3.The incidence rate of NMS is positively correlated with duration of disease(r=0.436,P<0.01),modified Hoehn-Yahr(H-Y)rating(r=0.255,P<0.05),not related to gender.4.Among 72 PD patients,63.9% had depression,91.7% had anxiety,81.9% had sleep disorder and 80.6% had cognitive dysfunction.PD patients accompanied depression are positively correlated with duration of disease(r=0.258,P<0.05),HAMA grading(r=0.519,P<0.01),PSQI grading(r=0.538,P<0.01),FS-14 grading(r=0.446,P<0.01),not related to gender.PD patients with anxiety associated with modified Hoehn-Yahr(H-Y)rating(c=0.247,P<0.05),are positively correlated with duration of disease(r=0.233,P<0.05),HAMD grading(r=0.268,P<0.05),not related to gender.PD patients with sleep disorders associated with modified Hoehn-Yahr(H-Y)rating(c=0.308,P<0.01),are positively correlated with duration of disease(r=0.281,P<0.05),HAMD grading(r=0.344,P<0.01),HAMD grading(r=0.344,P <0.01),HAMA grading(r=0.266,P<0.05),FS-14 grading(r=0.292,P<0.05),are negatively correlated with MoCA grading(r=-0.292,P<0.05).PD patients with cognitive dysfunction are associated with modified Hoehn-Yahr(H-Y)rating(c=0.263,P<0.05),is positively correlated with FS-14 grading(r=0.275,P<0.05),not related to age and educational level.Conclusion1.The most common non-motor symptoms of PD patients are constipation,memory loss,sadness and depression.2.The incidence rate of NMS is positively correlated with duration of disease,modified Hoehn-Yahr(H-Y)rating.3.The incidence of PD patients accompanied with depression,anxiety,sleep disorders,cognitive dysfunction is high,which are correlated with duration of disease,modified Hoehn-Yahr(H-Y)rating and FS-14 grading.