Body side and predominant motor features at the onset of Parkinson's disease are linked to motor and nonmotor progression
ABSTRACT Patients with Parkinson's disease most often have asymmetric motor features at onset, and specific motor signs (ie, tremor versus bradykinesia and rigidity) frequently characterize the first few years of disease evolution. Some previous clinical evidence has suggested that body side an...
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Veröffentlicht in: | Movement disorders 2014-02, Vol.29 (2), p.207-213 |
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description | ABSTRACT
Patients with Parkinson's disease most often have asymmetric motor features at onset, and specific motor signs (ie, tremor versus bradykinesia and rigidity) frequently characterize the first few years of disease evolution. Some previous clinical evidence has suggested that body side and a predominance of motor manifestations at disease onset are linked to long‐term evolution and disease progression. We prospectively analyzed 206 patients with Parkinson's disease according to the most affected side and predominant motor signs at onset. Patients were divided into left‐side rigid‐akinetic (n = 71), right‐side rigid‐akinetic (n = 59), left‐side tremor (n = 41), and right‐side tremor (n = 35) subgroups. These subgroups were compared in terms of motor and cognitive functions, mean motor deterioration per year (calculated as the motor score divided by disease duration), total equivalent doses of dopaminergic drugs, and the presence of hallucinations and rapid eye movement sleep behavior disorder. Disease duration was similar in all groups. Motor fluctuations were more likely to occur in rigid‐akinetic patients. In a multiple model analysis adjusted for potential confounders, faster disease progression was associated with right‐side (P = 0.045) and rigid‐akinetic onset (P = 0.001). With respect to nonmotor symptoms, the rigid‐akinetic type was associated with increased risk of cognitive decline (P = 0.004) compared with the tremor type. A trend was noticed toward an increased risk of developing visual hallucinations in rigid‐akinetic patients and toward an increased frequency of rapid eye movement sleep behavior disorder in those who had left‐sided onset of symptoms. Our findings corroborate that body side and type of motor signs at the time of diagnosis affect the evolution of motor severity and may also have an impact on some nonmotor manifestations. © 2013 Movement Disorder Society |
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Patients with Parkinson's disease most often have asymmetric motor features at onset, and specific motor signs (ie, tremor versus bradykinesia and rigidity) frequently characterize the first few years of disease evolution. Some previous clinical evidence has suggested that body side and a predominance of motor manifestations at disease onset are linked to long‐term evolution and disease progression. We prospectively analyzed 206 patients with Parkinson's disease according to the most affected side and predominant motor signs at onset. Patients were divided into left‐side rigid‐akinetic (n = 71), right‐side rigid‐akinetic (n = 59), left‐side tremor (n = 41), and right‐side tremor (n = 35) subgroups. These subgroups were compared in terms of motor and cognitive functions, mean motor deterioration per year (calculated as the motor score divided by disease duration), total equivalent doses of dopaminergic drugs, and the presence of hallucinations and rapid eye movement sleep behavior disorder. Disease duration was similar in all groups. Motor fluctuations were more likely to occur in rigid‐akinetic patients. In a multiple model analysis adjusted for potential confounders, faster disease progression was associated with right‐side (P = 0.045) and rigid‐akinetic onset (P = 0.001). With respect to nonmotor symptoms, the rigid‐akinetic type was associated with increased risk of cognitive decline (P = 0.004) compared with the tremor type. A trend was noticed toward an increased risk of developing visual hallucinations in rigid‐akinetic patients and toward an increased frequency of rapid eye movement sleep behavior disorder in those who had left‐sided onset of symptoms. Our findings corroborate that body side and type of motor signs at the time of diagnosis affect the evolution of motor severity and may also have an impact on some nonmotor manifestations. © 2013 Movement Disorder Society</description><identifier>ISSN: 0885-3185</identifier><identifier>EISSN: 1531-8257</identifier><identifier>DOI: 10.1002/mds.25650</identifier><identifier>PMID: 24105646</identifier><identifier>CODEN: MOVDEA</identifier><language>eng</language><publisher>United States: Blackwell Publishing Ltd</publisher><subject>Aged ; akinesia ; Antiparkinson Agents - therapeutic use ; Cognition Disorders - etiology ; Disease Progression ; Female ; Functional Laterality - drug effects ; Functional Laterality - physiology ; Hallucinations - diagnosis ; Hallucinations - etiology ; Human Body ; Humans ; Hypokinesia - diagnosis ; Hypokinesia - etiology ; Male ; Middle Aged ; Movement disorders ; Muscle Rigidity - etiology ; Parkinson Disease - complications ; Parkinson Disease - drug therapy ; Parkinson Disease - pathology ; Parkinson's disease ; prognosis ; REM Sleep Behavior Disorder - etiology ; Severity of Illness Index ; tremor ; Tremor - etiology</subject><ispartof>Movement disorders, 2014-02, Vol.29 (2), p.207-213</ispartof><rights>2013 Movement Disorder Society</rights><rights>2013 Movement Disorder Society.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4570-c3f8558cdc8c76dfee65c3723b6eeff13d2c7a0580fd60c33c79093d79a1dde73</citedby><cites>FETCH-LOGICAL-c4570-c3f8558cdc8c76dfee65c3723b6eeff13d2c7a0580fd60c33c79093d79a1dde73</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fmds.25650$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fmds.25650$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>315,781,785,1418,27929,27930,45579,45580</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24105646$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Baumann, Christian R.</creatorcontrib><creatorcontrib>Held, Ulrike</creatorcontrib><creatorcontrib>Valko, Philipp O.</creatorcontrib><creatorcontrib>Wienecke, Miriam</creatorcontrib><creatorcontrib>Waldvogel, Daniel</creatorcontrib><title>Body side and predominant motor features at the onset of Parkinson's disease are linked to motor and nonmotor progression</title><title>Movement disorders</title><addtitle>Mov Disord</addtitle><description>ABSTRACT
Patients with Parkinson's disease most often have asymmetric motor features at onset, and specific motor signs (ie, tremor versus bradykinesia and rigidity) frequently characterize the first few years of disease evolution. Some previous clinical evidence has suggested that body side and a predominance of motor manifestations at disease onset are linked to long‐term evolution and disease progression. We prospectively analyzed 206 patients with Parkinson's disease according to the most affected side and predominant motor signs at onset. Patients were divided into left‐side rigid‐akinetic (n = 71), right‐side rigid‐akinetic (n = 59), left‐side tremor (n = 41), and right‐side tremor (n = 35) subgroups. These subgroups were compared in terms of motor and cognitive functions, mean motor deterioration per year (calculated as the motor score divided by disease duration), total equivalent doses of dopaminergic drugs, and the presence of hallucinations and rapid eye movement sleep behavior disorder. Disease duration was similar in all groups. Motor fluctuations were more likely to occur in rigid‐akinetic patients. In a multiple model analysis adjusted for potential confounders, faster disease progression was associated with right‐side (P = 0.045) and rigid‐akinetic onset (P = 0.001). With respect to nonmotor symptoms, the rigid‐akinetic type was associated with increased risk of cognitive decline (P = 0.004) compared with the tremor type. A trend was noticed toward an increased risk of developing visual hallucinations in rigid‐akinetic patients and toward an increased frequency of rapid eye movement sleep behavior disorder in those who had left‐sided onset of symptoms. Our findings corroborate that body side and type of motor signs at the time of diagnosis affect the evolution of motor severity and may also have an impact on some nonmotor manifestations. © 2013 Movement Disorder Society</description><subject>Aged</subject><subject>akinesia</subject><subject>Antiparkinson Agents - therapeutic use</subject><subject>Cognition Disorders - etiology</subject><subject>Disease Progression</subject><subject>Female</subject><subject>Functional Laterality - drug effects</subject><subject>Functional Laterality - physiology</subject><subject>Hallucinations - diagnosis</subject><subject>Hallucinations - etiology</subject><subject>Human Body</subject><subject>Humans</subject><subject>Hypokinesia - diagnosis</subject><subject>Hypokinesia - etiology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Movement disorders</subject><subject>Muscle Rigidity - etiology</subject><subject>Parkinson Disease - complications</subject><subject>Parkinson Disease - drug therapy</subject><subject>Parkinson Disease - pathology</subject><subject>Parkinson's disease</subject><subject>prognosis</subject><subject>REM Sleep Behavior Disorder - etiology</subject><subject>Severity of Illness Index</subject><subject>tremor</subject><subject>Tremor - etiology</subject><issn>0885-3185</issn><issn>1531-8257</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kUFvFCEYQInR2G314B8wJB6sh2lhGGD2WFdbbepqosYjofChtDOwAhPdfy_rbHsw8URI3vcg30PoGSUnlJD2dLT5pOWCkwdoQTmjTd9y-RAtSN_zhtGeH6DDnG8IoZRT8RgdtB0lXHRigbavo93i7C1gHSzeJLBx9EGHgsdYYsIOdJkSZKwLLj8Ax5Ch4OjwJ51ufcgxvMzY-gw6V0UCPPhwCxaXuBfstCGG-bJJ8XuVZR_DE_TI6SHD0_15hL6ev_2yetdcfbx4vzq7akzHJWkMcz3nvbGmN1JYByC4YbJl1wLAOcpsa6QmvCfOCmIYM3JJlszKpabWgmRH6Hj21rd_TpCLGn02MAw6QJyyopx0HW9lSyr64h_0Jk4p1N_tqLox0tK-Uq9myqSYcwKnNsmPOm0VJWrXQ9Ue6m-Pyj7fG6frEew9eRegAqcz8MsPsP2_SX148_lO2cwTPhf4fT9RayghmeTq2_pC8RVZd5frS3XO_gCcf6S3</recordid><startdate>201402</startdate><enddate>201402</enddate><creator>Baumann, Christian R.</creator><creator>Held, Ulrike</creator><creator>Valko, Philipp O.</creator><creator>Wienecke, Miriam</creator><creator>Waldvogel, Daniel</creator><general>Blackwell Publishing Ltd</general><general>Wiley Subscription Services, Inc</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>P64</scope><scope>RC3</scope><scope>7X8</scope></search><sort><creationdate>201402</creationdate><title>Body side and predominant motor features at the onset of Parkinson's disease are linked to motor and nonmotor progression</title><author>Baumann, Christian R. ; Held, Ulrike ; Valko, Philipp O. ; Wienecke, Miriam ; Waldvogel, Daniel</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4570-c3f8558cdc8c76dfee65c3723b6eeff13d2c7a0580fd60c33c79093d79a1dde73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Aged</topic><topic>akinesia</topic><topic>Antiparkinson Agents - therapeutic use</topic><topic>Cognition Disorders - etiology</topic><topic>Disease Progression</topic><topic>Female</topic><topic>Functional Laterality - drug effects</topic><topic>Functional Laterality - physiology</topic><topic>Hallucinations - diagnosis</topic><topic>Hallucinations - etiology</topic><topic>Human Body</topic><topic>Humans</topic><topic>Hypokinesia - diagnosis</topic><topic>Hypokinesia - etiology</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Movement disorders</topic><topic>Muscle Rigidity - etiology</topic><topic>Parkinson Disease - complications</topic><topic>Parkinson Disease - drug therapy</topic><topic>Parkinson Disease - pathology</topic><topic>Parkinson's disease</topic><topic>prognosis</topic><topic>REM Sleep Behavior Disorder - etiology</topic><topic>Severity of Illness Index</topic><topic>tremor</topic><topic>Tremor - etiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Baumann, Christian R.</creatorcontrib><creatorcontrib>Held, Ulrike</creatorcontrib><creatorcontrib>Valko, Philipp O.</creatorcontrib><creatorcontrib>Wienecke, Miriam</creatorcontrib><creatorcontrib>Waldvogel, Daniel</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Movement disorders</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Baumann, Christian R.</au><au>Held, Ulrike</au><au>Valko, Philipp O.</au><au>Wienecke, Miriam</au><au>Waldvogel, Daniel</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Body side and predominant motor features at the onset of Parkinson's disease are linked to motor and nonmotor progression</atitle><jtitle>Movement disorders</jtitle><addtitle>Mov Disord</addtitle><date>2014-02</date><risdate>2014</risdate><volume>29</volume><issue>2</issue><spage>207</spage><epage>213</epage><pages>207-213</pages><issn>0885-3185</issn><eissn>1531-8257</eissn><coden>MOVDEA</coden><abstract>ABSTRACT
Patients with Parkinson's disease most often have asymmetric motor features at onset, and specific motor signs (ie, tremor versus bradykinesia and rigidity) frequently characterize the first few years of disease evolution. Some previous clinical evidence has suggested that body side and a predominance of motor manifestations at disease onset are linked to long‐term evolution and disease progression. We prospectively analyzed 206 patients with Parkinson's disease according to the most affected side and predominant motor signs at onset. Patients were divided into left‐side rigid‐akinetic (n = 71), right‐side rigid‐akinetic (n = 59), left‐side tremor (n = 41), and right‐side tremor (n = 35) subgroups. These subgroups were compared in terms of motor and cognitive functions, mean motor deterioration per year (calculated as the motor score divided by disease duration), total equivalent doses of dopaminergic drugs, and the presence of hallucinations and rapid eye movement sleep behavior disorder. Disease duration was similar in all groups. Motor fluctuations were more likely to occur in rigid‐akinetic patients. In a multiple model analysis adjusted for potential confounders, faster disease progression was associated with right‐side (P = 0.045) and rigid‐akinetic onset (P = 0.001). With respect to nonmotor symptoms, the rigid‐akinetic type was associated with increased risk of cognitive decline (P = 0.004) compared with the tremor type. A trend was noticed toward an increased risk of developing visual hallucinations in rigid‐akinetic patients and toward an increased frequency of rapid eye movement sleep behavior disorder in those who had left‐sided onset of symptoms. Our findings corroborate that body side and type of motor signs at the time of diagnosis affect the evolution of motor severity and may also have an impact on some nonmotor manifestations. © 2013 Movement Disorder Society</abstract><cop>United States</cop><pub>Blackwell Publishing Ltd</pub><pmid>24105646</pmid><doi>10.1002/mds.25650</doi><tpages>7</tpages></addata></record> |
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subjects | Aged akinesia Antiparkinson Agents - therapeutic use Cognition Disorders - etiology Disease Progression Female Functional Laterality - drug effects Functional Laterality - physiology Hallucinations - diagnosis Hallucinations - etiology Human Body Humans Hypokinesia - diagnosis Hypokinesia - etiology Male Middle Aged Movement disorders Muscle Rigidity - etiology Parkinson Disease - complications Parkinson Disease - drug therapy Parkinson Disease - pathology Parkinson's disease prognosis REM Sleep Behavior Disorder - etiology Severity of Illness Index tremor Tremor - etiology |
title | Body side and predominant motor features at the onset of Parkinson's disease are linked to motor and nonmotor progression |
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