Objective: To describe the distribution of NMS of PD in patients assisted by the Outpatient Neurology Service between 2012 and 2016 in a high level hospital in Cali – Colombia.

Background: Parkinson Disease (PD) is characterized by motor symptoms, however, non-motor symptoms (NMS) such as REM sleep Behavior Disorder (RBD), Hyposmia, depression, constipation, among others that can appear in the premotor stage of PD, preceding it`s diagnosis by years. To date, there is no literature regarding the frequency of NMS in a first consultation in PD patients in Colombia.

Methods: Observational, descriptive cross-sectional study. From 48010 neurological consults, 225 medical records were selected (Fig 1). From the selected patients, clinical and sociodemographic data was collected in the first consultation.  Prodromal NMS and motor symptoms to PD diagnosis were assessed by interrogation. A statistical inference was performed using odds ratio of NMS and motor symptoms; the significant level was P<0.05. All statistical analysis was performed using STATA-13.0.  

Results: Sociodemographic data is shown in Table 1. There were 23.6% of patients in the premotor group that only presented NMS in the first consult but later in follow up developed motor symptoms and were diagnosed with PD whitin the next 5 years. From the group that presented motor symptoms during the first consult, 91 (40.4%) had a previous diagnosis of PD, 64 (28.4%) were diagnosed during the first consultation and 70 (31.0%) were diagnosed in follow ups. Frequency of NMS was RBD 48.8%, hyposmia 29.7%, cognitive symptoms 24.8%, psychiatric and behavioral symptoms 51.1% and autonomic symptoms 28.5%. Odds-ratio analysis between the most frequent non-motor symptoms and the predominant motor feature are presented in Table 2.

Conclusions: In the cohort, 23.6% of the patients with NMS were diagnosed within 5 years after the first consultation during follow up. Asking about NMS can be a useful tool to screen early stages of the disease and improve the diagnostic accuracy. In the sample, RBD and Hyposmia were the most frequent NMS with a higher degree of relation with bradykinesia and rigidity and a lower degree of relation with tremor. The relationship between RBD and bradykinesia has been established and it could be considered as a risk factor for PD phenotype characterized for postural instability and gait disorders.

References: Bugalho P, Viana-Baptista, M (2013). REM sleep behavior disorder and motor dysfunction in Parkinson’s disease – A longitudinal study. Parkinsonism Relat Disord, doi: 10.1016/j.parkreldis.2013.07.017.

Takeda A, Baba T, Kikuchi A, Hasegawa T, Sugeno N, Konno M, Miura E, Mori E (2014) Olfactory dysfunction and dementia in Parkinson´s disease. J Parkinsons Dis. doi: 10.3233/JPD-130277.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/non-motor-symptoms-in-the-first-neurology-consultation-in-cali-colombia/