Conference Coverage
PORTLAND, OR —Autonomic symptoms are present in a majority of patients with early Parkinson's disease, and symptoms correlate with markers of disease severity and impaired quality of life, according to research presented at the Fourth World Parkinson Congress.
Although autonomic dysfunction is common in the later stages of Parkinson's disease, less is known about autonomic symptom presence and severity in early stages of Parkinson's disease. Naveed Malek, MD, Department of Neurology, Institute of Neurological Sciences, Queen Elizabeth University Hospital, in Glasgow, and colleagues conducted a study to explore the prevalence, range, and severity of autonomic symptoms in a cohort of patients who had been diagnosed with Parkinson's disease in the preceding 3.5 years.
Naveed Malek, MD
The researchers analyzed detailed patient-reported symptoms of autonomic dysfunction that were assessed in the multicenter United Kingdom Tracking Parkinson's study using the Scale for Outcomes in Parkinson's Disease for Autonomic Symptoms (SCOPA-AUT).
The researchers assessed the relationship between baseline SCOPA-AUT score and baseline motor, nonmotor, and quality of life scores. The researchers adjusted for sex, age, and disease duration differences across groups.
A total of 1,738 patients (65.1% male, mean age 67.6) were included in the main analysis. Patients had a mean disease duration of 1.3 years and mean Movement Disorder Society Unified Parkinson's Disease Rating Scale motor score of 22.5. Hoehn and Yahr was stage 1 or 1.5 in 855 cases (49.2%), stage 2 or 2.5 in 783 cases (45.1%), and stage 3 or higher in 100 cases (5.8%).
Autonomic severity by SCOPA-AUT score increased significantly across the motor severity stages, from 10.7 for Hoehn and Yahr stages 1 and 1.5, to 12.7 for Hoehn and Yahr stages 2 and 2.5, and to 13.5 for Hoehn and Yahr stages 3 and higher. Urinary, bowel, and sexual dysfunctions were the most commonly reported autonomic symptoms. The results were between those previously reported in controls and in patients with Parkinson's disease at a mean duration of 10 years. Positive associations were present between autonomic severity and depression, sleep disturbance, and postural instability motor subtype.
"Our study highlights the extent to which we may expect to see autonomic features in early Parkinson's disease, and the relationship between autonomic features and diagnostic consideration, which is important in the balanced diagnostic judgment approach emphasized in recent consensus guidelines," Dr. Malek concluded.
—Jake Remaly