The Non-Motor Burden of Parkinson’s Disease: Experience from an Eastern Indian Tertiary Center
Keywords:
Sleep disturbances, Hyposmia, Nonmotor burden, Parkinson’s diseaseAbstract
Abstract Views: 30
Background: Parkinson’s disease (PD) is defined by motor signs, but non‑motor symptoms (NMS) – neuropsychiatric, autonomic, sleep, sensory, and cognitive – often arise early, drive disability, and reduce health‑related quality of life (HRQoL). Regional NMS profiles can inform screening and management.
Methods: We conducted a cross‑sectional study at a tertiary hospital in Eastern India. Consecutive adults with idiopathic PD (Hoehn & Yahr stages 1–4) underwent structured assessment using validated instruments: NMS questionnaire, NMS scale (NMSS), Montreal Cognitive Assessment (MoCA), Beck Depression Inventory (BDI‑II), Beck Anxiety Inventory, Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), PD Questionnaire‑39 (PDQ‑39), Visual Analog Scale for pain, and King’s PD pain scale. Demographic and clinical data were recorded. Descriptive statistics summarized prevalence and severity; comparative analyses explored associations between NMS burden and patient characteristics.
Results: A total of 150 patients (mean age ~63 years; male ≈ two‑thirds; disease duration ~7 years) were included. The NMS burden was high: Depression affected approximately half, insomnia about one‑third, and cognitive impairment around two‑fifths. Constipation and orthostatic hypotension were frequent autonomic problems, whereas olfactory dysfunction and pain were also common. Mean PSQI scores reflected poor sleep quality. Higher NMS burden correlated with worse HRQoL.
Conclusion: NMS are ubiquitous in this Eastern Indian PD cohort and substantially impact HRQoL. Routine, structured NMS screening alongside motor evaluation should be the standard of care. Region‑aware, multidisciplinary strategies addressing mood, sleep, cognition, autonomic dysfunction, and pain are essential.
References
Lee HM, Koh S. Many faces of Parkinson’s disease:
Non-motor symptoms. J Mov Disord 2015;8:92-7.
Ou R, Hou Y, Wei Q, Lin J, Liu K, Zhang L, et al.
Longitudinal evolution of non-motor symptoms in early
Parkinson’s disease: 3-year cohort. NPJ Parkinsons Dis
;7:58.
Yuan M, Xu Q, Han M, Pan H. Early diagnosis and
mechanisms of NMS in Parkinson’s: Editorial. Front Neurol
;15:1434924.
Zhu J, Zhong M, Yan J, Jiang X, Wu Z, Pan Y, et al.
Non-motor symptoms affect sleep quality in early PD. Front
Neurol 2020;11:292.
van Wamelen DJ, Sauerbier A, Leta V, Rodriguez-Blazquez C,
Falup-Pecurariu C, Rodriguez-Violante M, et al. Crosssectional
analysis of the Parkinson’s disease Non-motor
International Longitudinal Study baseline non-motor
characteristics, geographical distribution and impact on
quality of life. Sci Rep 2021;11:9611.
Kumaresan M, Khan S. Spectrum of non-motor symptoms
in PD. Cureus 2021;13:e13275.
Todorova A, Jenner P, Chaudhuri KR. Non-motor PD:
Integral yet neglected. Pract Neurol 2014;14:310-22.
Simuni T, Sethi KD. Non-motor manifestations of PD. Ann
Neurol 2009;64:S65-80.
Zis P, Erro R, Walton CC, Sauerbier A, Chaudhuri KR.
Non-motor symptoms in drug-naïve PD: Systematic review.
NPJ Parkinsons Dis 2015;1:15013.
Martínez-Martín P, Chaudhuri KR. Comprehensive grading
using motor and non-motor assessments. Expert Rev
Neurother 2018;18:41-50.
Fernandes M, Pierantozzi M, Stefani A, Cattaneo C,
Bonizzoni EA, Cerroni R, et al. Frequency of NMS in PD
with motor fluctuations. Front Neurol 2021;12:678373.
Niccolini F, Wilson H, Giordano B, Diamantopoulos K,
Pagano G, Chaudhuri KR, et al. Sleep/GI dysfunction and
thalamic atrophy in PD. BMC Neurosci 2019;20:55.
Ratti P, Nègre-Pagès L, Perez-Lloret S, Manni R, Damier P,
Tison F, et al. Insomnia in PD: CoPark cohort. Parkinsonism
Relat Disord 2015;21:1323-9.
Diaconu Ș, Falup-Pecurariu C. Personalized assessment of
insomnia in PD. J Pers Med 2022;12:322.
Fujita H, Shiina T, Sakuramoto H, Nozawa N, Ogaki K,
Suzuki K. Sleep and autonomic features with probable RBD
in PD. Front Neurosci 2022;16:874349.
Taximaimaiti R, Luo X, Wang X. Treatments of sleep
disorders in PD. Curr Neuropharmacol 2021;19:2233-51.
Alwardat M, Grillo P, Schirinzi T, Pavese C, Salimei C,
Pisani A, et al. Constipation and pain in PD: Clinical analysis.
J Neural Transm 2024;131:165-72.
Lin C, Chaudhuri KR, Fan JY, Ko CI, Rizos A, Chang CW,
et al. Depression, COMT variants and pain in PD. Sci Rep
;7:6306.
Carpi M, Pierantozzi M, Cofano S, Fernandes M, Cerroni R,
De Cillis F, et al. Motor and non-motor fluctuations in PD
management. J Pers Med 2023;13:242.
Prange S, Danaila T, Laurencin C, Caire C, Metereau E,
Merle H, et al. Age and time course of long-term
complications in PD. Neurology 2019;92:e148-60.
Kadastik-Eerme L, Muldmaa M, Lilles S, Rosenthal M,
Taba N, Taba P. Key factors associated with NMS.
Parkinsons Dis 2016;2016:4370674.
Rodríguez-Sánchez F, Rodríguez-Blázquez C, Bielza C,
Larrañaga P, Weintraub D, Martinez-Martin P, et al.
Subtypes with motor and NMS via clustering. Sci Rep
;11:23645.
Liu Y, Zhu X, Zhang XJ, Kuo SH, Ondo WG, Wu YC.
Clinical features with and without RBD. Transl
Neurodegener 2017;6:35.
Al-Khammash N, Al-Jabri N, Albishi A, Al-Onazi A, Aseeri S,
Alotaibi F, et al. QoL in PD: Crosssectional study. Cureus
;15:e33989.
Loo RTJ, Pavelka L, Mangone G, Khoury F, Vidailhet M,
Corvol JC, et al. Predictors of cognitive impairment in PD:
Multi-cohort ML. NPJ Digit Med 2025;8:482.
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