Burden of nonmotor symptoms in Parkinson’s disease patients from eastern India

BACKGROUND: Parkinson’s disease (PD) is classically characterized by motor features. However, nonmotor symptoms (NMSs) represent an important aspect of the disease with a significant impact on quality of life (QoL). OBJECTIVES: The aim of this study was to evaluate NMS in patients with PD, to determine their various correlates, and to assess the impact on QoL. METHODS: This cross-sectional study included 150 consecutive patients with PD and 150 age- and sex-matched healthy controls. NMSs were assessed using the NMS Questionnaire (NMSQuest) and NMS Scale (NMSS). QoL was evaluated by the 8-item Parkinson’s Disease Questionnaire scored as summary index (PDQ-8-SI). RESULTS: Every patient experienced NMS and 90% had more than five NMSs. Patients with PD had a significantly higher prevalence of NMS compared to healthy controls. The most common NMSs in patients with PD were unexplained pain, anxiety, constipation, insomnia, and memory impairment. Miscellaneous was the most prevalent domain of NMSS, followed by sleep/fatigue, gastrointestinal tract, and mood/cognition. Attention/memory impairment and pain were greater in females. Cardiovascular/falls and perceptual/hallucination showed a positive correlation with duration of disease. Sexual dysfunction decreased with increasing age. In the young-onset group (YOPD), mood/cognition involvement was higher. PDQ-8-SI showed a significant correlation with total NMSS score and most of the individual domain scores. Contrary to other Indian studies, our patients reported restless legs more frequently, whereas urinary symptoms were less common. Our observations showed a greater prevalence of pain and constipation compared to the Western studies. CONCLUSIONS: All of our patients experienced NMS. The prevalence of various NMS in our study showed differences with previous reports. NMS had a significant impact on QoL.