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Staging Parkinson’s Disease Combining Motor and Nonmotor Symptoms Correlates with Disability and Quality of Life

2021; Hindawi Publishing Corporation; Volume: 2021; Linguagem: Inglês

10.1155/2021/8871549

2090-8083

Diego Santos‐García, T. de Deus Fonticoba, Jose M. Paz González, Carlos Cores Bartolomé, Lorena Valdés Aymerich, José Guillermo Muñoz Enríquez, Ester Suárez, Silvia Jesús, M. Aguilar, Pau Pástor, Lluís Planellás, Marina Cosgaya, Juan García Caldentey, Núria Caballol, I. Legarda, Jorge Hernández‐Vara, Iria Cabo, Lydia López Manzanares, Isabel González Aramburu, María A. Ávila Rivera, M. J. Catalán, Víctor Nogueira, Víctor Puente, J M García-Moreno, C. Borrué, Berta Solano Vila, María Álvarez Saúco, Lydia Vela, Sonia Escalante, Esther Cubo, Francisco Carrillo Padilla, Juan Carlos Martínez‐Castrillo, Pilar Sánchez Alonso, Maria G. Alonso Losada, Núria López Ariztegui, Itziar Gastón, Jaime Kulisevsky, Marta Blázquez Estrada, Manuel Seijo, Javier Ruiz‐Martínez, C. Valero, Mónica Kurtis, Oriol de Fábregues, Jessica González Ardura, Carlos Ordás, Luis López Díaz, Mir P, Pablo Martínez‐Martín, COPPADIS Study Group,

Restless Legs Syndrome Research

Introduction. In a degenerative disorder such as Parkinson’s disease (PD), it is important to establish clinical stages that allow to know the course of the disease. Our aim was to analyze whether a scale combining Hoehn and Yahr’s motor stage (H&Y) and the nonmotor symptoms burden (NMSB) (assessed by the nonmotor symptoms scale (NMSS)) provides information about the disability and the patient’s quality of life (QoL) with regard to a defined clinical stage. Materials and Methods. Cross-sectional study in which 603 PD patients from the COPPADIS cohort were classified according to H&Y (1, stage I; 2, stage II; 3, stage III; 4, stage IV/V) and NMSB (A: NMSS = 0–20; B: NMSS = 21–40; C: NMSS = 41–70; D: NMSS ≥ 71) in 16 stages (HY.NMSB, from 1A to 4D). QoL was assessed with the PDQ-39SI, PQ-10, and EUROHIS-QOL8 and disability with the Schwab&England ADL (Activities of Daily Living) scale. Results. A worse QoL and greater disability were observed at a higher stage of H&Y and NMSB ( p < 0.0001 ). Combining both (HY.NMSB), patients in stages 1C and 1D and 2C and 2D had significantly worse QoL and/or less autonomy for ADL than those in stages 2A and 2B and 3A and 3B, respectively ( p < 0.005 ; e.g., PDQ-39SI in 1D [n = 15] vs 2A [n = 101]: 28.6 ± 17.1 vs 7.9 ± 5.8; p < 0.0001 ). Conclusion. The HY.NMSB scale is simple and reflects the degree of patient involvement more accurately than the H&Y. Patients with a lower H&Y stage may be more affected if they have a greater NMS burden.