Lower Urinary Tract and Gastrointestinal Dysfunction Are Common in Early Parkinson’s Disease
Purpose. Autonomic dysfunction is a common nonmotor feature and early manifestation of Parkinsons disease (PD). Autonomic dysfunction in PD is associated with a worse prognosis. We sought to characterize autonomic dysfunction and identify associated factors in patients with early PD. Methods. An obs...
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| Format: | Article |
| Language: | English |
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Wiley
2020-01-01
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| Series: | Parkinson's Disease |
| Online Access: | http://dx.doi.org/10.1155/2020/1694547 |
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| author | Daniel Martinez-Ramirez Edna Sophia Velazquez-Avila Alejandro Almaraz-Espinoza Arnulfo Gonzalez-Cantú Genaro Vazquez-Elizondo Daniel Overa-Posada Amin Cervantes-Arriaga Mayela Rodriguez-Violante Mirna Gonzalez-Gonzalez |
| author_facet | Daniel Martinez-Ramirez Edna Sophia Velazquez-Avila Alejandro Almaraz-Espinoza Arnulfo Gonzalez-Cantú Genaro Vazquez-Elizondo Daniel Overa-Posada Amin Cervantes-Arriaga Mayela Rodriguez-Violante Mirna Gonzalez-Gonzalez |
| author_sort | Daniel Martinez-Ramirez |
| collection | DOAJ |
| description | Purpose. Autonomic dysfunction is a common nonmotor feature and early manifestation of Parkinsons disease (PD). Autonomic dysfunction in PD is associated with a worse prognosis. We sought to characterize autonomic dysfunction and identify associated factors in patients with early PD. Methods. An observational, cross-sectional, descriptive, and analytical study was conducted to evaluate patients with early PD from the Parkinsons Progression Markers Initiative. We utilized the Scales for Outcomes in Parkinsons Disease-Autonomic dysfunction questionnaire to determine the prevalence and frequencies of autonomic symptomatology. The cohort was grouped into high and low dysautonomic scores. A regression model identified variables that independently explained dysautonomic scores in our early PD cohort. Results. 414 PD patients had a mean age of 61.1 (SD 9.7) years at diagnosis and mean disease duration of 6.7 (SD 6.6) months. Among all patients, 43.7% (181/414) had high dysautonomic scores. Urinary and gastrointestinal symptoms were the most prevalent and frequently reported dysautonomic symptoms. Patients with fatigue (beta = 4.28, p<0.001), probable rapid eye movement sleep behavior disorder (beta = 2.71, p<0.001), excessive daytime sleepiness (beta = 1.88,p=0.039), impulsivity and compulsivity (beta = 2.42, p<0.001), and increasing age (beta = 1.05, p<0.001) were more likely to have high dysautonomic scores. Conclusion. Lower urinary tract and gastrointestinal symptoms are prevalent and frequent in early PD patients. Fatigue, sleep disorders, impulsivity and compulsivity, and age are predictors of autonomic dysfunction. Autonomic symptoms predominated in this group of early PD patients in the disease course and were associated with more severe disease. |
| format | Article |
| id | doaj-art-89ce45f8175b42c2bfcd1fab6d33043f |
| institution | Kabale University |
| issn | 2090-8083 2042-0080 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Parkinson's Disease |
| spelling | doaj-art-89ce45f8175b42c2bfcd1fab6d33043f2025-02-03T00:58:52ZengWileyParkinson's Disease2090-80832042-00802020-01-01202010.1155/2020/16945471694547Lower Urinary Tract and Gastrointestinal Dysfunction Are Common in Early Parkinson’s DiseaseDaniel Martinez-Ramirez0Edna Sophia Velazquez-Avila1Alejandro Almaraz-Espinoza2Arnulfo Gonzalez-Cantú3Genaro Vazquez-Elizondo4Daniel Overa-Posada5Amin Cervantes-Arriaga6Mayela Rodriguez-Violante7Mirna Gonzalez-Gonzalez8Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Ave. Morones Prieto 3000, Monterrey 64710, Nuevo Leon, MexicoTecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Ave. Morones Prieto 3000, Monterrey 64710, Nuevo Leon, MexicoTecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Ave. Morones Prieto 3000, Monterrey 64710, Nuevo Leon, MexicoChristus Muguerza Alta Especialidad, Ave. Hidalgo 2525, Monterrey 64060, Nuevo Leon, MexicoOncare Gastrointestinal Services, Calz. San Pedro 255, San Pedro Garza Garcia 66220, Nuevo Leon, MexicoTecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Ave. Morones Prieto 3000, Monterrey 64710, Nuevo Leon, MexicoMovement Disorders Clinic, National Institute of Neurology and Neurosurgery, Ave. Insurgentes Sur 3877, La Fama 14269, Mexico City, MexicoMovement Disorders Clinic, National Institute of Neurology and Neurosurgery, Ave. Insurgentes Sur 3877, La Fama 14269, Mexico City, MexicoTecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Ave. Morones Prieto 3000, Monterrey 64710, Nuevo Leon, MexicoPurpose. Autonomic dysfunction is a common nonmotor feature and early manifestation of Parkinsons disease (PD). Autonomic dysfunction in PD is associated with a worse prognosis. We sought to characterize autonomic dysfunction and identify associated factors in patients with early PD. Methods. An observational, cross-sectional, descriptive, and analytical study was conducted to evaluate patients with early PD from the Parkinsons Progression Markers Initiative. We utilized the Scales for Outcomes in Parkinsons Disease-Autonomic dysfunction questionnaire to determine the prevalence and frequencies of autonomic symptomatology. The cohort was grouped into high and low dysautonomic scores. A regression model identified variables that independently explained dysautonomic scores in our early PD cohort. Results. 414 PD patients had a mean age of 61.1 (SD 9.7) years at diagnosis and mean disease duration of 6.7 (SD 6.6) months. Among all patients, 43.7% (181/414) had high dysautonomic scores. Urinary and gastrointestinal symptoms were the most prevalent and frequently reported dysautonomic symptoms. Patients with fatigue (beta = 4.28, p<0.001), probable rapid eye movement sleep behavior disorder (beta = 2.71, p<0.001), excessive daytime sleepiness (beta = 1.88,p=0.039), impulsivity and compulsivity (beta = 2.42, p<0.001), and increasing age (beta = 1.05, p<0.001) were more likely to have high dysautonomic scores. Conclusion. Lower urinary tract and gastrointestinal symptoms are prevalent and frequent in early PD patients. Fatigue, sleep disorders, impulsivity and compulsivity, and age are predictors of autonomic dysfunction. Autonomic symptoms predominated in this group of early PD patients in the disease course and were associated with more severe disease.http://dx.doi.org/10.1155/2020/1694547 |
| spellingShingle | Daniel Martinez-Ramirez Edna Sophia Velazquez-Avila Alejandro Almaraz-Espinoza Arnulfo Gonzalez-Cantú Genaro Vazquez-Elizondo Daniel Overa-Posada Amin Cervantes-Arriaga Mayela Rodriguez-Violante Mirna Gonzalez-Gonzalez Lower Urinary Tract and Gastrointestinal Dysfunction Are Common in Early Parkinson’s Disease Parkinson's Disease |
| title | Lower Urinary Tract and Gastrointestinal Dysfunction Are Common in Early Parkinson’s Disease |
| title_full | Lower Urinary Tract and Gastrointestinal Dysfunction Are Common in Early Parkinson’s Disease |
| title_fullStr | Lower Urinary Tract and Gastrointestinal Dysfunction Are Common in Early Parkinson’s Disease |
| title_full_unstemmed | Lower Urinary Tract and Gastrointestinal Dysfunction Are Common in Early Parkinson’s Disease |
| title_short | Lower Urinary Tract and Gastrointestinal Dysfunction Are Common in Early Parkinson’s Disease |
| title_sort | lower urinary tract and gastrointestinal dysfunction are common in early parkinson s disease |
| url | http://dx.doi.org/10.1155/2020/1694547 |
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