Non‐motor symptom burden is strongly correlated to motor complications in patients with Parkinson’s disease

Abstract

Objective The objective of this study was to analyze the relationship between motor complications and non‐motor symptoms (NMS) burden in a population of Parkinson’s disease (PD) and also in a subgroup of early PD patients. Methods PD patients from the COPPADIS cohort were included in this cross‐sectional study. NMS burden was defined according to the NMSS (Non‐Motor Symptoms Scale) total score. UPDRS (Unified Parkinson´s Disease Rating Scale) part‐IV was used to establish motor complication types and their severity. Patients with ≤ 5 years of symptoms from onset were included as early PD patients. Results Out of 690 PD patients (62.6±8.9 years old, 60.1% males), 33.9% and 18.1% presented motor fluctuations and dyskinesia, respectively. NMS total score was higher in patients with motor fluctuations (59.2±43.1 vs 38.3±33.1;p<0.0001) and dyskinesia (63.5±40.7 vs 41.4±36.3;p<0.0001). In a multiple linear regression model and after adjustment to age, sex, disease duration, H&Y, UPDRS‐III, and levodopa equivalent daily dose, UPDRS‐IV was significantly related to a higher NMSS total score (β=0.27; 95%CI 2.81‐5.61;p40, severe or very severe): OR=1.31; 95%CI 1.17‐1.47; p<0.0001. In the subgroup of early PD patients (n=396; mean disease duration 2.7±1.5 years), motor fluctuations were frequent (18.1%) and similar results were obtained. Conclusions Motor complications are frequent and are associated with a greater NMS burden in PD patients even during the first 5 years of disease duration.