Change in Motor and Nonmotor Symptoms Severity in a "Real-Life" Cohort of Subjects with Parkinson's Disease.

Abstract

Background. Parkinson's disease (PD) is a chronic and progressive disorder. Rates of change in motor symptoms have been more studied compared to nonmotor symptoms. The objective was to describe these changes in a real-life cohort of subjects with PD. Methods. A cohort study was carried out from 2011 to 2013. Consecutive patients with PD were recruited from a movement disorders clinic. MDS-UPDRS, PDQ-8, and NMSS were applied to all subjects at an initial evaluation and a subsequent visit (21 ± 3 months). Disease severity was categorized using a recent classification of MDS-UPDRS severity. Results. The MDS-UPDRS Part III showed a significant decrease of 7.2 ± 2.31 points (p = 0.001) between evaluations. A mean increase of 0.9 ± 0.6 points (p = 0.015) in the MDS-UPDRS Part IV was observed. An increase of 14.3 ± 11.4 points (p = 0.043) in the NMSS total score was found; when assessed individually, the difference was statistically significant only for the perceptual problems/hallucinations item. Quality of life remained unchanged. Conclusion. Motor improvement was observed accompanied by an increase in motor complications possibly as a result of treatment optimization. Nonmotor symptoms worsened as a whole. The overall effect in the quality of life was negligible.