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Autonomic and sensory symptoms and signs in incident, untreated Parkinson's disease: Frequent but mild

Authors

  • Bernd Müller MD,

    Corresponding author
    1. Department of Neurology, Haukeland University Hospital, Bergen, Norway
    2. Institute for clinical medicine, University of Bergen, Bergen, Norway
    • Department of Neurology, Haukeland University Hospital, 5021 Bergen, Norway
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  • Jan Petter Larsen PhD,

    1. Institute for clinical medicine, University of Bergen, Bergen, Norway
    2. Department of Neurology, Stavanger University Hospital, Stavanger, Norway
    3. The Norwegian Centre for Movement Disorders, Stavanger, Norway
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  • Tore Wentzel-Larsen MSc,

    1. Centre for clinical research, Haukeland University Hospital, Bergen, Norway
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  • Geir Olve Skeie PhD,

    1. Department of Neurology, Haukeland University Hospital, Bergen, Norway
    2. Institute for clinical medicine, University of Bergen, Bergen, Norway
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  • Ole-Bjørn Tysnes PhD,

    1. Department of Neurology, Haukeland University Hospital, Bergen, Norway
    2. Institute for clinical medicine, University of Bergen, Bergen, Norway
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  • for The Parkwest Study Group


  • Members of the “Parkwest Study Group” are listed as an Appendix.

  • Potential conflict of interest: The authors have no potential conflicts of interest to report

Abstract

Although nonmotor symptoms are increasingly recognized as key features in Parkinson's disease (PD), the occurrence and severity of autonomic and sensory symptoms in patients with very early and untreated PD are poorly documented. Two hundred seven patients with newly diagnosed, untreated PD and 175 controls from the population-based Norwegian ParkWest study were included. Postural blood pressure and olfactory function were measured and eight autonomic and sensory symptoms assessed using interview-based rating scales. Autonomic and sensory symptoms were more frequent in patients compared with controls (mean number of symptoms 2.9 vs. 1.1; P < 0.001) and in the postural instability and gait difficulty motor-subtype vs. tremor dominant subtype (mean 3.3 vs. 2.5; P = 0.008). In the patient group, reduced olfaction (59%), urinary problems (47%), increased saliva or drooling (42%), constipation (39%), and sensory complaints (34%) were the most frequent symptoms. Daily activities were not affected by these symptoms in 58% of the patients, and the influence on daily activities was rated as “mild” or less for all of these symptoms in 90%. A higher Hoehn and Yahr stage was associated with a higher number of autonomic and sensory symptoms and with the occurrence of gastrointestinal symptoms. Autonomic and sensory symptoms are common in patients with untreated, early PD although the severity of these symptoms is mild, with little or no influence on daily activities. The high prevalence of increased saliva or drooling close to the time of diagnosis is noteworthy and not described earlier. © 2010 Movement Disorder Society

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