Objective: To analyze the frequency and differences in distribution by sex and disease severity of non-motor symptoms (NMS) in patients with Parkinson’s disease (PD) using the Movement Disorder Society-Non-Motor Rating Scale (MDS-NMS).

Background: NMS are frequent in PD (Martinez-Martin et al, 2007), and a determinant of impaired quality of life. The MDS-NMS can increase our knowledge of the prevalence and correlates of NMS in PD patients.

Method: A sample of 402 PD patients recruited in UK and USA for the MDS-NMS validation study. The Hoehn and Yahr staging system (HY), the MDS-NMS, including its non-motor fluctuations (NMF) subscale, the Non-Motor Symptoms scale (NMSS) and the Movement Disorders Society-Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) were all administered. For the prevalence of NMS and NMF, percentage of positive scores (i.e., ≥1) in items, domains and total scores of the rating scales were computed. The distribution of NMS and NMF by HY severity levels was calculated and differences ascertained using Fisher’s and chi-squared tests.

Results: The sample was composed by 62.2% of men, and had a mean age of 67.42 (standard deviation, SD=9.96) years and disease duration of 8.20 (SD=5.93) years. Median HY stage was 2 (54.48% of the sample). Using the MDS-NMS, patients showed a mean of 16.13 NMS (SD: 9.36; range: 0-46), and 99.7% presented with a NMS. The most prevalent symptoms were muscle, joint or back pain (67.4%), difficulty remembering things (59.0%) and urinary urgency (57.2%). Least prevalent NMS were dopamine dysregulation syndrome (2.2%), punding (4.0%) and delusions (4.5%). Using the NMSS, the most frequent NMS was forgetting things (52.5%), and the least frequent was hallucinations (3.7%). With the MDS-NMS Part I, daytime sleepiness (72.3%) was the most frequent, and features of dopamine dysregulation syndrome (7.0%) was the least common. NMF were present in 41% (N=165) of the sample, with fatigue (68.5% patients with NMF) and anxiety (62.4%) being the more common. MDS-NMS domains Depression, Apathy, Psychosis, Cognition, Orthostatic Hypotension, Urinary and Gastrointestinal showed a significant increase in prevalence by increasing HY severity levels (p<0.05).

Conclusion: NMS and NMF are highly prevalent in PD, with some differences by disease severity. The MDS-NMS can help to understand the distribution and profiles of NMS in PD patients.

References: Martinez-Martin P, Schapira AH, Stocchi F, et al. Prevalence of nonmotor symptoms in Parkinson’s disease in an international setting; study using nonmotor symptoms questionnaire in 545 patients. Mov Disord. 2007;22(11):1623–1629. doi:10.1002/mds.21586

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MDS Abstracts - https://www.mdsabstracts.org/abstract/prevalence-of-non-motor-symptoms-in-parkinsons-disease-using-the-movement-disorder-society-non-motor-rating-scale-mds-nms-and-comparable-scales/