J Clin Neurol.  2016 Oct;12(4):393-402. 10.3988/jcn.2016.12.4.393.

The KMDS-NATION Study: Korean Movement Disorders Society Multicenter Assessment of Non-Motor Symptoms and Quality of Life in Parkinson's Disease NATION Study Group

• Kwon DY
• Koh SB
• Lee JH
• Park HK
• Kim HJ
• Shin HW
• Youn J
• Park KW
• Choi SA
• Kim SJ
• Choi SM
• Park JY
• Jeon BS
• Kim JY
• Chung SJ
• Lee CS
• Park JH
• Ahn TB
• Kim WC
• Kim HS
• Cheon SM
• Kim HT
• Lee JY
• Kim JS
• Kim EJ
• Kim JM
• Lee KS
• Kim JS
• Kim MJ
• Baik JS
• Park KJ
• Kim HJ
• Park MY
• Kang JH
• Song SK
• Kim YD
• Yun JY
• Lee HW
• Oh HG
• Cho J
• Song IU
• Sohn YH
• Lee PH
• Kim JW

• KMID: 2385101
• DOI: http://doi.org/10.3988/jcn.2016.12.4.393

Abstract

BACKGROUND AND PURPOSE
Nonmotor symptoms (NMS) in Parkinson's disease (PD) have multisystem origins with heterogeneous manifestations that develop throughout the course of PD. NMS are increasingly recognized as having a significant impact on the health-related quality of life (HrQoL). We aimed to determine the NMS presentation according to PD status, and the associations of NMS with other clinical variables and the HrQoL of Korean PD patients.
METHODS
We surveyed patients in 37 movement-disorders clinics throughout Korea. In total, 323 PD patients were recruited for assessment of disease severity and duration, NMS, HrQoL, and other clinical variables including demographics, cognition, sleep scale, fatigability, and symptoms.
RESULTS
In total, 98.1% of enrolled PD subjects suffered from various kinds of NMS. The prevalence of NMS and scores in each NMS domain were significantly higher in the PD group, and the NMS worsened as the disease progressed. Among clinical variables, disease duration and depressive mood showed significant correlations with all NMS domains (p<0.001). NMS status impacted HrQoL in PD (rS=0.329, p<0.01), and the association patterns differed with the disease stage.
CONCLUSIONS
The results of our survey suggest that NMS in PD are not simply isolated symptoms of degenerative disease, but rather exert significant influences throughout the disease course. A novel clinical approach focused on NMS to develop tailored management strategies is warranted to improve the HrQoL in PD patients.

Keyword

Parkinson's disease; non-motor symptoms; quality of life

MeSH Terms

Cognition
Demography
Humans
Korea
Movement Disorders*
Parkinson Disease*
Prevalence
Quality of Life*

Figure

• 

  Fig. 1 Scores of domain (or items) of NMSS according to the subgroup of PD patients (de novo:early:advanced). CV: cardiovascular, GI: gastrointestinal, NMSS: non-motor symptom scale, PD: Parkinson's disease.

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  Fig. 2 Correlations between NMSS total score and PDQ39 SI (rS=0.329, p<0.001). NMSS: non-motor symptom scale, PDQ39: Parkinson's Disease Questionnaire-39, PDQ39 SI: PDQ39 summary index.

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