Objective: To increase early recognition of these symptoms, by investigating the frequency of nonmotor symptoms (NMS) in patients with Parkinson’s disease (PD) who have early morning off (EMO) period.

Background: It is predicted that the frequency of NMS observed in the EMO period of PD will increase in this period and negatively affect the health related quality of life.

Method: In our study, we evaluated 90 idiopathic PD patients who experienced EMO period in terms of the frequency of NMS in this period. Affecting the frequency of NMS; the patient’s age, gender, motor subtype at disease onset, disease duration, disease onset age, disease stage, total levodopa equivalent dose (LED) value of the antiparkinsonian drugs, cognitive status, presence and degree of depression, and excessive sleepiness during the day were questioned. Nonmotor Symptoms Assesment Scale (NMSQuest- Turkish version) for the frequency of NMS and Parkinson’s Disease Questionnaire (PHA-39) for quality of life was applied to each patient. The relationship between NMS and quality of life was investigated in patients.

Results: The average number of NMS in PD patients who experience EMO period is 14 (3-25). Sleep problems in 95.6% of patients, gastrointestinal system problems in 93.3%, other problems (pain, weight loss, edema in the legs, double vision and sweating) in 86.7%, mood problems in 85.6%, urinary system problems in 77.8%, attention and memory problems 77.8%  , sexual problems in 55.6%, cardiovascular system problems in 50% and perception problems in 43.3% were observed. In our study, linear relationship between gastrointestinal symptom (p=0,024) – total NMS (p=0,035) severity and Modified Hoehn Yahr stage was found to be statistically significant. A positive statistically significant relationship was found between PHA-39 and gastrointestinal (r:0.486, p<0.001), attention / memory (r:0.381, p=0.002), mood (r:0.405, p<0.001),other problems (r:0.244, p:0.031) and total NMS (r:0.667, p<0.001).

Conclusion: NMS during the EMO period can occur in various stages of PD from early stage to advanced disease and is strongly correlated with the progression of the disease. Also, the higher the frequency of NMS in the PD patients, the worse the quality of life related to health. Adequate data on the relationship between EMO period and NMS are not available in the literature.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/frequency-of-nonmotor-symptoms-parkinsons-disease-in-the-early-morning-off-period/