Academic Journal

The longitudinal progression of autonomic dysfunction in Parkinson's disease: A 7-year study

التفاصيل البيبلوغرافية
العنوان: The longitudinal progression of autonomic dysfunction in Parkinson's disease: A 7-year study
المؤلفون: Charlotte B. Stewart, David Ledingham, Victoria K. Foster, Kirstie N. Anderson, Sahana Sathyanarayana, Debra Galley, Nicola Pavese, Jacopo Pasquini
المصدر: Frontiers in Neurology, Vol 14 (2023)
بيانات النشر: Frontiers Media S.A., 2023.
سنة النشر: 2023
المجموعة: LCC:Neurology. Diseases of the nervous system
مصطلحات موضوعية: autonomic dysfunction, SCOPA-AUT, PPMI (Parkinson's progression markers initiative), olfactory dysfunction, Parkinson's disease, Neurology. Diseases of the nervous system, RC346-429
الوصف: BackgroundAutonomic dysfunction, including gastrointestinal, cardiovascular, and urinary dysfunction, is often present in early Parkinson's Disease (PD). However, the knowledge of the longitudinal progression of these symptoms, and the connection between different autonomic domains, is limited. Furthermore, the relationship between the presence of autonomic symptoms in early-stage PD and olfactory dysfunction, a possible marker of central nervous system involvement, has not been fully investigated.ObjectivesWe aimed to investigate the occurrence and progression of autonomic dysfunction in recently diagnosed (< 2 years) untreated PD patients and determine any coexistence of symptoms in individual patients. We also investigated the relationship between autonomic symptoms, olfactory dysfunction, and motor impairment.MethodsData were obtained from the Parkinson's Progression Markers Initiative (PPMI) database. Autonomic dysfunction was measured using the Scales for Outcomes in Parkinson's Disease (SCOPA-AUT). Symptom frequency and mean scores over 7 years were determined. The simultaneous occurrence of different autonomic symptoms was also examined. Finally, the relationships between SCOPA-AUT scores, olfactory dysfunction, and motor impairment were investigated using the University of Pennsylvania Smell Identification Test (UPSIT) and the Movement Disorder Society—Unified Parkinson's Disease Rating Scale (MDS-UPDRS), respectively.ResultsFollow-up data were available for 7 years for 171 PD patients and for 5 years for 136 HCs. Mean SCOPA-AUT score increased significantly from baseline to the 7-year follow-up for each autonomic domain, except for female sexual dysfunction. Most patients reported three or more autonomic symptoms. Common clusters of symptoms were composed of combinations of gastrointestinal, urinary, thermoregulatory, and sexual dysfunction. At baseline, greater SCOPA-AUT total score was associated with lower UPSIT scores (r = −0.209, p = 0.006) and with greater total MDS-UDPRS III score (r = 0.218, p = 0.004).ConclusionsAutonomic dysfunction, often with coexistence of autonomic manifestations, is common in early PD and progressively worsens over the first 7 years of disease, suggesting that these symptoms should be addressed with appropriate treatments early in the disease. The association between greater autonomic dysfunction and greater olfactory impairment, coupled with the association with more severe motor scores at baseline, indicates that patients who show more severe autonomic dysfunction could also have more severe involvement of the central nervous system at the time of diagnosis.
نوع الوثيقة: article
وصف الملف: electronic resource
اللغة: English
تدمد: 1664-2295
Relation: https://www.frontiersin.org/articles/10.3389/fneur.2023.1155669/full; https://doaj.org/toc/1664-2295
DOI: 10.3389/fneur.2023.1155669
URL الوصول: https://doaj.org/article/521339ff200e4fcb9287d6e08f00d4bd
رقم الانضمام: edsdoj.521339ff200e4fcb9287d6e08f00d4bd
قاعدة البيانات: Directory of Open Access Journals
الوصف
تدمد:16642295
DOI:10.3389/fneur.2023.1155669