The clinical profile of nonmotor fluctuations in Parkinson's disease patients

Abstract

Objective: Recently described nonmotor fluctuations may cause disability in Parkinson's disease patients. These fluctuations are generally grouped as sensory, autonomic and cognitive/psychiatric. The clinical spectrum and frequency of these symptoms among patients with fluctuating Parkinson's disease are unknown. Methods: We studied the correlation of nonmotor fluctuations with motor symptoms and determined the effect of age at disease onset, duration of disease, dosage and duration of levodopa treatment to the occurrence of nonmotor fluctuations. Results: The statistical analysis showed a positive correlation of all above criteria with sensory and autonomic fluctuations. Whereas, cognitive-psychiatric fluctuations were found to be only correlated with the duration of levodopa usage. The nonmotor fluctuations included in the study were observed during "on" period as well as "off" and "end dose off" periods. Conclusion: The variability of nonmotor fluctuations in clinical presentation and coappearance of these fluctuations with different types of motor fluctuations were considered as the effect of other neurotransmitter systems acting syncronously with dopamine. In this study, we determined the high risk factors for nonmotor fluctuations in patients with Parkinson's disease.