Objective: To clarify the clinical manifestations of nonmotor symptoms (NMSs) and identify factors affecting NMSs and quality of life (QOL) in Japanese patients with Parkinson’s disease (PD).

Background: PD is the most common neurodegenerative movement disorder. Dopamine replacement is an effective therapy for motor symptoms associated with PD; the alleviation of such symptoms results in improvements in both clinical prognosis and QOL. Recent clinical research in PD also revealed multiple and variable NMSs. NMSs are clinically important as a factor in deteriorating QOL. However, dopamine replacement therapy is generally ineffective in treating NMSs, and there is insufficient evidence on clinical management of NMSs. We planned an observational study in Japan that investigated not only the prevalence of NMSs in PD, but clinical factors having an impact on NMSs and/or QOL.

Methods: PD patients with ≥1 NMS and wearing-off under anti-Parkinsonian treatment were enrolled in the 52-week observational study. The correlation between NMSs and QOL, and the factors that impact them will be assessed, as will the effect of anti-Parkinsonian treatment on NMS and QOL.

Results: Between March 2014 and January 2015, 1021 patients from 35 movement disorder centers in Japan were enrolled. A total of 996 patients were included in the 52-week study; 13 patients withdrew consent and 12 patients were excluded because they had no “off” time. Baseline clinical characteristics were statistically analyzed. The mean age was 68.1 years, 62.7% of patients were female, and the mean disease duration was 10.9 years. Mean MDS-UPDRS part I and PDQ-8 scores were 10.9 and 7.3, respectively. Frequent NMSs included: constipation (85.4%), sleep disorders (73.7%), and excessive daytime sleepiness (72.0%); these showed significant associations with age, clinical severity of parkinsonism and anti-Parkinsonian medications. Positive correlations were observed between MDS-UPDRS part I and PDQ-8 scores (p<0.001, r=0.56).

Conclusions: This is the first prospective, multicenter, large-scale, observational study investigating the prevalence of NMSs and QOL in PD patients in Japan. This baseline study may reveal distinctive patterns of NMSs of Japanese PD patients and clarify whether NMSs affect patients’ QOL. Note: The authors represent a study group (J-FIRST group).

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MDS Abstracts - https://www.mdsabstracts.org/abstract/j-first-first-in-japan-observational-study-of-parkinsons-disease-treatments-and-nonmotor-symptoms/