As Parkinson's disease (PD) progresses, non motor symptoms (NMS) can fluctuate either along or irrespective to motor fluctuations. Predictors of motor fluctuation have been extensively studied. Yet, the predictors of development of non motor fluctuations (NMF) are less clear. Herein, we show the results of a prospective study on the relationship between NMF and gender along with other potential risk factors. Early, drug-naive patients with PD have been enrolled and followed up for 4 years since diagnosis. NMF were assessed with the 19-item Wearing off Questionnaire (WOQ-19). Associations were explored by means of multivariable logistic regression models for binary outcomes (WOQ-19 Total score≥?2 and WOQ-19 Non motor score≥?1) and multivariable ordered logistic regression models for ordinal variables (WOQ-19 Total score and WOQ-19 Non motor score). Models were adjusted for age of onset, NMSQuestionnaire, UPDRS-III and Levodopa intake. Fully completed WOQ-19 were available for 47 (16 women and 31 men) out of 75 patients enrolled, who, therefore, represented the cohort considered in the present study. At 4-year visit and according to the WOQ-19 Total score cut-off, wearing off symptoms were present more frequently in women [12(75%)versus 14 men(45.2%),p=0.04]. Accordingly, there was a trend towards significance for higher WOQ-19 Total scores in women compared to men [4(6)versus 1 (5), p=0.06]. NMF were more frequently reported by women compared with men [10(62.5%) versus 8(25.8%), p=0.01), with particular regard to anxiety, mood changes and pain (p=0.05, 0.03 and 0.01 respectively). Correspondingly, the WOQ-19 Non motor score was higher in women compared with men [1.5(3) versus 0(1), p=0.01]. No gender differences were detected in motor fluctuations. According to multivariable logistic regression models, female gender represented a risk factor for a diagnosis of NMF (adjusted odds ratio,AOR=5.33,95%CI=1.21-23.4,p<0.05), but not for diagnosis of generic wearing off at 4 years (OR=3.66,95%CI=0.8-16.8,p<0.05). According to multivariable ordered logistic regression models, at T4 women tended to develop higher WOQ-19 Non motor scores (AOR=4.58,95%CI=1.23-17.03,p<0.05) but not higher WOQ-19 Total scores (AOR=2.88,95%CI=0.86-9.71,p<0.05) compared to men. We showed that female gender represented the most important risk factor for the development of NMF after 4 years since PD diagnosis, irrespective of levodopa intake, motor disability and NMS burden at diagnosis

Gender and non motor fluctuations in Parkinson's disease: a prospective study

VITALE, Carmine;
2016-01-01

Abstract

As Parkinson's disease (PD) progresses, non motor symptoms (NMS) can fluctuate either along or irrespective to motor fluctuations. Predictors of motor fluctuation have been extensively studied. Yet, the predictors of development of non motor fluctuations (NMF) are less clear. Herein, we show the results of a prospective study on the relationship between NMF and gender along with other potential risk factors. Early, drug-naive patients with PD have been enrolled and followed up for 4 years since diagnosis. NMF were assessed with the 19-item Wearing off Questionnaire (WOQ-19). Associations were explored by means of multivariable logistic regression models for binary outcomes (WOQ-19 Total score≥?2 and WOQ-19 Non motor score≥?1) and multivariable ordered logistic regression models for ordinal variables (WOQ-19 Total score and WOQ-19 Non motor score). Models were adjusted for age of onset, NMSQuestionnaire, UPDRS-III and Levodopa intake. Fully completed WOQ-19 were available for 47 (16 women and 31 men) out of 75 patients enrolled, who, therefore, represented the cohort considered in the present study. At 4-year visit and according to the WOQ-19 Total score cut-off, wearing off symptoms were present more frequently in women [12(75%)versus 14 men(45.2%),p=0.04]. Accordingly, there was a trend towards significance for higher WOQ-19 Total scores in women compared to men [4(6)versus 1 (5), p=0.06]. NMF were more frequently reported by women compared with men [10(62.5%) versus 8(25.8%), p=0.01), with particular regard to anxiety, mood changes and pain (p=0.05, 0.03 and 0.01 respectively). Correspondingly, the WOQ-19 Non motor score was higher in women compared with men [1.5(3) versus 0(1), p=0.01]. No gender differences were detected in motor fluctuations. According to multivariable logistic regression models, female gender represented a risk factor for a diagnosis of NMF (adjusted odds ratio,AOR=5.33,95%CI=1.21-23.4,p<0.05), but not for diagnosis of generic wearing off at 4 years (OR=3.66,95%CI=0.8-16.8,p<0.05). According to multivariable ordered logistic regression models, at T4 women tended to develop higher WOQ-19 Non motor scores (AOR=4.58,95%CI=1.23-17.03,p<0.05) but not higher WOQ-19 Total scores (AOR=2.88,95%CI=0.86-9.71,p<0.05) compared to men. We showed that female gender represented the most important risk factor for the development of NMF after 4 years since PD diagnosis, irrespective of levodopa intake, motor disability and NMS burden at diagnosis
2016
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11367/51739
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