Research Article

The impact of non-motor symptoms on health-related quality of life of patients with Parkinson's disease^†^‡

Corresponding Author

Pablo Martinez-Martin MD, PhD

[email protected]

Area of Applied Epidemiology, National Centre of Epidemiology and CIBERNED, Carlos III Institute of Health, Madrid, Spain

Scientific Management, Alzheimer Disease Research Unit, CIEN Foundation, Carlos III Institute of Health, Alzheimer Center Reina Sofia Foundation, Madrid, Spain

National Centre of Epidemiology, Carlos III Institute of Health, Av. Monforte de Lemos, 5. Madrid 28029, SpainSearch for more papers by this author

Carmen Rodriguez-Blazquez BS,

Carmen Rodriguez-Blazquez BS

Area of Applied Epidemiology, National Centre of Epidemiology and CIBERNED, Carlos III Institute of Health, Madrid, Spain

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Monica M. Kurtis MD,

Monica M. Kurtis MD

Movement Disorders Unit, Department of Neurology, Ruber International Hospital, Madrid, Spain

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K. Ray Chaudhuri MD, FRCP, DSC,

K. Ray Chaudhuri MD, FRCP, DSC

National Parkinson Foundation Centre of Excellence, Kings College Hospital, London, United Kingdom

Department of Neurology, University Hospital Lewisham, Kings College, London, United Kingdom

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on Behalf of the NMSS Validation Group,

on Behalf of the NMSS Validation Group

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Pablo Martinez-Martin MD, PhD,

Corresponding Author

Pablo Martinez-Martin MD, PhD

[email protected]

Area of Applied Epidemiology, National Centre of Epidemiology and CIBERNED, Carlos III Institute of Health, Madrid, Spain

Scientific Management, Alzheimer Disease Research Unit, CIEN Foundation, Carlos III Institute of Health, Alzheimer Center Reina Sofia Foundation, Madrid, Spain

National Centre of Epidemiology, Carlos III Institute of Health, Av. Monforte de Lemos, 5. Madrid 28029, SpainSearch for more papers by this author

Carmen Rodriguez-Blazquez BS,

Carmen Rodriguez-Blazquez BS

Area of Applied Epidemiology, National Centre of Epidemiology and CIBERNED, Carlos III Institute of Health, Madrid, Spain

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Monica M. Kurtis MD,

Monica M. Kurtis MD

Movement Disorders Unit, Department of Neurology, Ruber International Hospital, Madrid, Spain

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K. Ray Chaudhuri MD, FRCP, DSC,

K. Ray Chaudhuri MD, FRCP, DSC

National Parkinson Foundation Centre of Excellence, Kings College Hospital, London, United Kingdom

Department of Neurology, University Hospital Lewisham, Kings College, London, United Kingdom

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on Behalf of the NMSS Validation Group,

on Behalf of the NMSS Validation Group

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First published: 24 January 2011

https://doi.org/10.1002/mds.23462

Citations: 718

^†

Relevant conflict of interest/financial disclosure: Nothing to report. Full financial disclosure and author roles may be found in the online version of this article.

^‡

Members of the NMSS Validation Group are listed as an Appendix.

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Abstract

Background:

Non-motor symptoms are detrimental to health-related quality of life (HRQoL) of Parkinson's disease patients. In this study, the Non-Motor Symptoms Scale (NMSS) was used to assess the impact of the non-motor symptoms on HRQoL of Parkinson's disease patients.

Methods:

In a multicenter, international, cross sectional study on 411 Parkinson's disease patients, the NMSS was applied along with clinical (Hoehn and Yahr staging and SCOPA-Motor) and HRQoL measures (PDQ-39, and EQ-5D). Prevalence of non-motor symptoms was determined also through the NMSS. The association of NMSS and SCOPA-Motor with HRQoL measures and the differences in HRQoL scores between patients with and without non-motor symptoms in each NMSS domain were estimated by non-parametric statistics. Predictors of HRQoL were sought through multiple linear regression analyses.

Results:

Nocturia (68.4% of the sample), fatigue (65.9%), and dribbling saliva (56.7%), were the most frequent complaints. Total NMSS score: (1) showed a higher correlation coefficient (r_S = 0.70) with the PDQ-39 Summary Index (SI) than SCOPA-Motor (r_S = 0.58); (2) showed high-moderate correlation (r_S = 0.60 − 0.38) with all PDQ-39 domains; and (3) was the best predictor of HRQoL as measured by the PDQ-39 SI. For each NMSS domain, patients with symptoms had significantly worse HRQoL scores than patients without symptoms.

Discussion:

To our knowledge, this is the first study to determine in a holistic manner the impact of the non-motor symptoms on HRQoL of Parkinson's disease patients. The results show that non-motor symptoms have, as a whole, a greater impact on HRQoL than motor symptoms and non-motor symptoms progression contributes importantly to HRQoL decline in patients with Parkinson's disease. © 2011 Movement Disorder Society

Supporting Information

References

1 Martinez-Martin P. An introduction to the concept of “quality of life in Parkinson's disease.” J Neurol 1998; 245( Suppl 1): S2–S6.
10.1007/PL00007733
PubMedWeb of Science®Google Scholar
2 Grosset KA, Grosset DG. Patient-perceived involvement and satisfaction in Parkinson's disease: effect on therapy decisions and quality of life. Mov Disord 2005; 20: 616–619.
10.1002/mds.20393
PubMedWeb of Science®Google Scholar
3 Karlsen KH, Larsen JP, Tandberg E, Maland JG. Quality of life measurements in patients with Parkinson's disease: A community-based study. Eur J Neurol 1998; 5: 443–450.
10.1046/j.1468-1331.1998.550443.x
CASPubMedWeb of Science®Google Scholar
4 Scaravilli T, Gasparoli E, Rinaldi F, Polesello G, Bracco F. Health-related quality of life and sleep disorders in Parkinson's disease. Neurol Sci 2003; 24: 209–210.
10.1007/s10072-003-0134-y
CASPubMedWeb of Science®Google Scholar
5 Chapuis S, Ouchchane L, Metz O, Gerbaud L, Durif F. Impact of the motor complications of Parkinson's disease on the quality of life. Mov Disord 2005; 20: 224–230.
10.1002/mds.20279
PubMedWeb of Science®Google Scholar
6 Karlsen KH, Larsen JP, Tandberg E, Maeland JG. Influence of clinical and demographic variables on quality of life in patients with Parkinson's disease. J Neurol Neurosurg Psychiatry 1999; 66: 431–435.
10.1136/jnnp.66.4.431
CASPubMedWeb of Science®Google Scholar
7 Klepac N, Pikija S, Kraljic T, et al. Association of rural life setting and poorer quality of life in Parkinson's disease patients: a cross-sectional study in Croatia. Eur J Neurol 2007; 14: 194–198.
10.1111/j.1468-1331.2006.01604.x
CASPubMedWeb of Science®Google Scholar
8 Ray J, Das SK, Gangopadhya PK, Roy T. Quality of life in Parkinson's disease—Indian scenario. J Assoc Physicians India 2006; 54: 17–21.
CASPubMedGoogle Scholar
9 Zhao YJ, Tan LC, Lau PN, Au WL, Li SC, Luo N. Factors affecting health-related quality of life amongst Asian patients with Parkinson's disease. Eur J Neurol 2008; 15: 737–742.
10.1111/j.1468-1331.2008.02178.x
CASPubMedWeb of Science®Google Scholar
10 Shulman LM, Taback RL, Rabinstein AA, Weiner WJ. Non recognition of depression and other non-motor symptoms in Parkinson's disease. Parkinsonism Relat Disord 2002; 8: 193–197.
10.1016/S1353-8020(01)00015-3
CASPubMedWeb of Science®Google Scholar
11 Chaudhuri KR, Prieto-Jurcynska C, Naidu Y, et al. The nondeclaration of nonmotor symptoms of Parkinson's disease to health care professionals: an international study using the nonmotor symptoms questionnaire. Mov Disord 2010; 25: 697–701.
10.1002/mds.22868
Web of Science®Google Scholar
12 Chaudhuri KR, Martinez-Martin P, Schapira AH, et al. International multicenter pilot study of the first comprehensive self-completed nonmotor symptoms questionnaire for Parkinson's disease: the NMSQuest study. Mov Disord 2006; 21: 916–923.
10.1002/mds.20844
CASPubMedWeb of Science®Google Scholar
13 Chaudhuri KR, Martinez-Martin P, Brown RG, et al. The metric properties of a novel non-motor symptoms scale for Parkinson's disease: results from an international pilot study. Mov Disord 2007; 22: 1901–1911.
10.1002/mds.21596
CASPubMedWeb of Science®Google Scholar
14 Martinez-Martin P, Rodriguez-Blazquez C, Abe K, et al. International study on the psychometric attributes of the non-motor symptoms scale in Parkinson disease. Neurology 2009; 73: 1584–1591.
10.1212/WNL.0b013e3181c0d416
CASPubMedWeb of Science®Google Scholar
15 Gibb WR, Lees AJ. The relevance of the Lewy body to the pathogenesis of idiopathic Parkinson's disease. J Neurol Neurosurg Psychiatry 1988; 51: 745–752.
10.1136/jnnp.51.6.745
CASPubMedWeb of Science®Google Scholar
16 EuroQol Group. EuroQol—a new facility for the measurement of health-related quality of life. The EuroQol Group. Health Policy 1990; 16: 199–208.
10.1016/0168-8510(90)90421-9
PubMedWeb of Science®Google Scholar
17 Jenkinson C, Fitzpatrick R, Peto V, Greenhall R, Hyman N. The Parkinson's Disease Questionnaire (PDQ-39): development and validation of a Parkinson's disease summary index score. Age Ageing 1997; 26: 353–357.
10.1093/ageing/26.5.353
CASPubMedWeb of Science®Google Scholar
18 Badia X, Herdman M, Kind P. The influence of ill-health experience on the valuation of health. Pharmacoeconomics 1998; 13: 687–696.
10.2165/00019053-199813060-00005
CASPubMedWeb of Science®Google Scholar
19 Schrag A, Selai C, Jahanshahi M, Quinn NP. The EQ-5D—a generic quality of life measure-is a useful instrument to measure quality of life in patients with Parkinson's disease. J Neurol Neurosurg Psychiatry 2000; 69: 67–73.
10.1136/jnnp.69.1.67
CASPubMedWeb of Science®Google Scholar
20 Grosset D, Taurah L, Burn DJ, et al. A multicentre longitudinal observational study of changes in self reported health status in people with Parkinson's disease left untreated at diagnosis. J Neurol Neurosurg Psychiatry 2007; 78: 465–469.
10.1136/jnnp.2006.098327
CASPubMedWeb of Science®Google Scholar
21 Hoehn MM, Yahr MD. Parkinsonism: onset, progression and mortality. Neurology 1967; 17: 427–442.
10.1212/WNL.17.5.427
CASPubMedWeb of Science®Google Scholar
22 Marinus J, Visser M, Stiggelbout AM, et al. A short scale for the assessment of motor impairments and disabilities in Parkinson's disease: the SPES/SCOPA. J Neurol Neurosurg Psychiatry 2004; 75: 388–395.
10.1136/jnnp.2003.017509
CASPubMedWeb of Science®Google Scholar
23 Schrag A, Jahanshahi M, Quinn N. What contributes to quality of life in patients with Parkinson's disease? J Neurol Neurosurg Psychiatry 2000; 69: 308–312.
10.1136/jnnp.69.3.308
CASPubMedWeb of Science®Google Scholar
24 Juniper EF, Guyatt GH, Jaeschke R. How to develop and validate a new health-related quality of life instrument. In: B Spilker, editor. Quality of life and pharmacoeconomics in clinical trials, Second ed. Philadelphia: Lippincott-Raven Publishers; 1996. p 49–56.
Google Scholar
25 Benjamini Y, Hochberg Y. Controlling the false discovery rate: a practical and powerful approach to multiple testing. J R Stat Soc 1995; 57: 289–300.
10.1111/j.2517-6161.1995.tb02031.x
Google Scholar
26 Sakakibara R, Shinotoh H, Uchiyama T, et al. Questionnaire-based assessment of pelvic organ dysfunction in Parkinson's disease. Auton Neurosci 2001; 92: 76–85.
10.1016/S1566-0702(01)00295-8
CASPubMedWeb of Science®Google Scholar
27 Chaudhuri KR, Healy DG, Schapira AH. Non-motor symptoms of Parkinson's disease: diagnosis and management. Lancet Neurol 2006; 5: 235–245.
10.1016/S1474-4422(06)70373-8
PubMedWeb of Science®Google Scholar
28 Wullner U, Schmitz-Hubsch T, Antony G, et al. Autonomic dysfunction in 3414 Parkinson's disease patients enrolled in the German Network on Parkinson's disease (KNP e.V.): the effect of ageing. Eur J Neurol 2007; 14: 1405–1408.
10.1111/j.1468-1331.2007.01982.x
CASPubMedWeb of Science®Google Scholar
29 Verbaan D, Marinus J, Visser M, van Rooden SM, Stiggelbout AM, van Hilten JJ. Patient-reported autonomic symptoms in Parkinson disease. Neurology 2007; 69: 333–341.
10.1212/01.wnl.0000266593.50534.e8
CASPubMedWeb of Science®Google Scholar
30 O'Sullivan SS, Williams DR, Gallagher DA, Massey LA, Silveira-Moriyama L, Lees AJ. Nonmotor symptoms as presenting complaints in Parkinson's disease: a clinicopathological study. Mov Disord 2008; 23: 101–106.
10.1002/mds.21813
PubMedWeb of Science®Google Scholar
31 Rahman S, Griffin HJ, Quinn NP, Jahanshahi M. Quality of life in Parkinson's disease: the relative importance of the symptoms. Mov Disord 2008; 23: 1428–1434.
10.1002/mds.21667
CASPubMedWeb of Science®Google Scholar
32 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: 1623–1629.
10.1002/mds.21586
CASPubMedWeb of Science®Google Scholar
33 Sammour ZM, Gomes CM, Barbosa ER, et al. Voiding dysfunction in patients with Parkinson's disease: impact of neurological impairment and clinical parameters. Neurourol Urodyn 2009; 28: 510–515.
10.1002/nau.20681
PubMedWeb of Science®Google Scholar
34 Barone P, Antonini A, Colosimo C, et al. The PRIAMO study: a multicenter assessment of nonmotor symptoms and their impact on quality of life in Parkinson's disease. Mov Disord 2009; 24: 1641–1649.
10.1002/mds.22643
CASPubMedWeb of Science®Google Scholar
35 Hughes AJ, Daniel SE, Blankson S, Lees AJ. A clinicopathologic study of 100 cases of Parkinson's disease. Arch Neurol 1993; 50: 140–148.
10.1001/archneur.1993.00540020018011
CASPubMedWeb of Science®Google Scholar
36 Honig H, Antonini A, Martinez-Martin P, et al. Intrajejunal levodopa infusion in Parkinson's disease: a pilot multicenter study of effects on nonmotor symptoms and quality of life. Mov Disord 2009; 24: 1468–1474.
10.1002/mds.22596
CASPubMedWeb of Science®Google Scholar
37 Martinez-Martin P, Catalan MJ, Benito-Leon J, et al. Impact of fatigue in Parkinson's disease: the Fatigue Impact Scale for Daily Use (D-FIS). Qual Life Res 2006; 15: 597–606.
10.1007/s11136-005-4181-0
PubMedWeb of Science®Google Scholar
38 Herlofson K, Larsen JP. The influence of fatigue on health-related quality of life in patients with Parkinson's disease. Acta Neurol Scand 2003; 107: 1–6.
10.1034/j.1600-0404.2003.02033.x
CASPubMedWeb of Science®Google Scholar
39 Qin Z, Zhang L, Sun F, et al. Health related quality of life in early Parkinson's disease: impact of motor and non-motor symptoms, results from Chinese levodopa exposed cohort. Parkinsonism Relat Disord 2009; 15: 767–771.
10.1016/j.parkreldis.2009.05.011
PubMedWeb of Science®Google Scholar
40 Marras C, McDermott MP, Rochon PA, Tanner CM, Naglie G, Lang AE. Predictors of deterioration in health-related quality of life in Parkinson's disease: results from the DATATOP trial. Mov Disord 2008; 23: 653–659.
10.1002/mds.21853
PubMedWeb of Science®Google Scholar
41 Celikel E, Ozel-Kizil ET, Akbostanci MC, Cevik A. Assessment of sexual dysfunction in patients with Parkinson's disease: a case–control study. Eur J Neurol 2008; 15: 1168–1172.
10.1111/j.1468-1331.2008.02278.x
CASPubMedWeb of Science®Google Scholar

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Volume26, Issue3

15 February 2011

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The impact of non-motor symptoms on health-related quality of life of patients with Parkinson's disease^†^‡

Abstract

Background:

Methods:

Results:

Discussion:

Supporting Information

References

Citing Literature

References

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The impact of non-motor symptoms on health-related quality of life of patients with Parkinson's disease†‡

Abstract

Background:

Methods:

Results:

Discussion:

Supporting Information

References

Citing Literature

References

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The impact of non-motor symptoms on health-related quality of life of patients with Parkinson's disease^†^‡