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

Author

D. Santos García, T. De Deus Fonticoba, J. M. Paz González, C. Cores Bartolomé, L. Valdés Aymerich, J. G. Muñoz Enríquez, E. Suárez, S. Jesús, M. Aguilar, P. Pastor, L. L. Planellas, M. Cosgaya, J. García Caldentey, N. Caballol, I. Legarda, J. Hernández Vara, I. Cabo, L. López Manzanares, I. González Aramburu, M. A. Ávila Rivera, M. J. Catalán, V. Nogueira, V. Puente, J. M. García Moreno, C. Borrué, B. Solano Vila, M. Álvarez Sauco, L. Vela, S. Escalante, E. Cubo, F. Carrillo Padilla, J. C. Martínez Castrillo, P. Sánchez Alonso, M. G. Alonso Losada, N. López Ariztegui, I. Gastón, J. Kulisevsky, M. Blázquez Estrada, M. Seijo, J. Rúiz Martínez, C. Valero, M. Kurtis, O. de Fábregues, J. González Ardura, C. Ordás, L. López Díaz, P. Mir, P. Martinez-Martin, and COPPADIS Study Group

Subjects
Neurology. Diseases of the nervous system, RC346-429
Abstract

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

Published
2021
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2. Sleep Problems Are Related to a Worse Quality of Life and a Greater Non-Motor Symptoms Burden in Parkinson's Disease

Author

J García Caldentey, Nuria Caballol, Pablo Mir, Lluís Planellas, I Cabo López, Lydia Vela, E Suárez Castro, L. López Manzanares, C Cores Bartolomé, J.C. Martínez Castrillo, J González Ardura, J G Muñoz Enriquez, J M Paz González, J Ruíz Martínez, N López Ariztegui, M I Gastón, J. Pagonabarraga, Diego Santos-García, T de Deus Fonticoba, M J Catalán, Jaime Kulisevsky, C Valero, Carlos Prieto, M J Feal Panceiras, Esther Cubo, M Seijo, M Álvarez Sauco, M G Alonso Losada, P Sánchez Alonso, I. Legarda, Monica M. Kurtis, Víctor Nogueira, Pablo Martinez-Martin, M A Ávila Rivera, and C Borrué

Subjects
Sleep Wake Disorders, Quality of life, medicine.medical_specialty, Parkinson's disease, Parkinson's disease sleep scale, Non-motor symptoms, 03 medical and health sciences, 0302 clinical medicine, Physical medicine and rehabilitation, Quality of life (healthcare), Surveys and Questionnaires, medicine, Humans, 030212 general & internal medicine, sleep, business.industry, Parkinson Disease, medicine.disease, Sleep in non-human animals, non-motor symptoms, Parkinson´s disease, Large cohort, Psychiatry and Mental health, Cross-Sectional Studies, quality of life, Non motor, Neurology (clinical), Geriatrics and Gerontology, Sleep, business, Parkinson´s disease sleep scale, 030217 neurology & neurosurgery
Abstract

COPPADIS Study Group., [Introduction] The aim of the present study was to examine the frequency of self-reported sleep problems and their associated factors in a large cohort of PD patients., [Methods] PD patients and controls, recruited from 35 centers of Spain from the COPPADIS cohort were included in this cross-sectional study. Sleep problems were assessed by the Spanish version of the Parkinson’s disease Sleep Scale version 1 (PDSS-1). An overall score below 82 or a score below 5 on at least 1 item was defined as sleep problems., [Results] The frequency of sleep problems was nearly double in PD patients compared to controls: 65.8% (448/681) vs 33.5% (65/206) (p < 0.0001). Mean total PDSS score was lower in PD patients than controls: 114.9 ± 28.8 vs 132.8 ± 16.3 (p < 0.0001). Quality of life (QoL) was worse in PD patients with sleep problems compared to those without: PDQ-39SI, 19.3 ± 14 vs 13 ± 11.6 (p < 0.0001); EUROHIS-QoL8, 3.7 ± 0.5 vs 3.9 ± 0.5 (p < 0.0001). Non-motor symptoms burden (NMSS; OR = 1.029; 95%CI 1.015–1.043; p < 0.0001) and impulse control behaviors (QUIP-RS; OR = 1.054; 95%CI 1.009–1.101; p = 0.018) were associated with sleep problems after adjustment for age, gender, disease duration, daily equivalent levodopa dose, H&Y, UPDRS-III, UPDRS-IV, PD-CRS, BDI-II, NPI, VAS-Pain, VAFS, FOGQ, and total number of non-antiparkinsonian treatments., [Conclusion] Sleep problems were frequent in PD patients and were related to both a worse QoL and a greater non-motor symptoms burden in PD. These findings call for increased awareness of sleep problems in PD patients.

Published
2021

3. Quality of life and non-motor symptoms in Parkinson's disease patients with subthreshold depression

Author

Lluís Planellas, L. López Manzanares, M G Alonso Losada, L Valdés Aymerich, J González Ardura, C Valero, C Cores Bartolomé, J Ruíz Martínez, Miquel Aguilar, J García Caldentey, I Gastón, M A Ávila Rivera, C Borrué, T de Deus Fonticoba, I Cabo López, Lydia Vela, C Prieto Jurczynska, E Suárez Castro, Nuria Caballol, M. Blázquez Estrada, M Álvarez Sauco, M J Feal Panceiras, Aaron Diaz, L.M. López Díaz, M J Catalán, M Seijo, Diego Santos-García, Silvia Jesús, J.C. Martínez Castrillo, Monica M. Kurtis, Berta Pascual-Sedano, Pablo Martinez-Martin, P. Mir, N López Ariztegui, J M Paz González, Esther Cubo, P Sánchez Alonso, J M García Moreno, and I. Legarda

Subjects
Quality of life, medicine.medical_specialty, Parkinson's disease, Non-motor symptoms, Disease, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Surveys and Questionnaires, Mood, medicine, Humans, In patient, 030212 general & internal medicine, Depression (differential diagnoses), Fatigue, business.industry, Depression, Parkinson Disease, medicine.disease, humanities, Neurology, Cohort, Quality of Life, Non motor, Neurology (clinical), business, 030217 neurology & neurosurgery
Abstract

Background: The role of subthreshold depression (subD) in Parkinson's Disease (PD) is not clear. The present study aimed to compare the quality of life (QoL) in PD patients with subD vs patients with no depressive disorder (nonD). Factors related to subD were identified. Material and methods: PD patients and controls recruited from the COPPADIS cohort were included. SubD was defined as Judd criteria. The 39-item Parkinson's disease Questionnaire (PDQ-39) and the EUROHIS-QOL 8-item index (EUROHIS-QOL8) were used to assess QoL. Results: The frequency of depressive symptoms was higher in PD patients (n = 694) than in controls (n = 207) (p < 0.0001): major depression, 16.1% vs 7.8%; minor depression, 16.7% vs 7.3%; subD, 17.4% vs 5.8%. Both health-related QoL (PDQ-39; 18.1 +/- 12.8 vs 11.6 +/- 10; p < 0.0001) and global QoL (EUROHIS-QOL8; 3.7 +/- 0.5 vs 4 +/- 0.5; p < 0.0001) were significantly worse in subD (n = 120) than nonD (n = 348) PD patients. Non-motor Symptoms Scale (NMSS) total score was higher in subD patients (45.9 +/- 32 vs 29.1 +/- 25.8;p < 0.0001). Non-motor symptoms burden (NMSS;OR = 1.019;95%CI 1.011-1.028; p < 0.0001), neuropsychiatric symptoms (NPI; OR = 1.091; 95%CI 1.045-1.139; p < 0.0001), impulse control behaviors (QUIP-RS; OR = 1.035; 95%CI 1.007-1063; p = 0.013), quality of sleep (PDSS; OR = 0.991; 95%CI 0.983-0.999; p = 0.042), and fatigue (VAFS-physical; OR = 1.185; 95%CI 1.086-1.293; p < 0.0001; VAFS-mental; OR = 1.164; 95%CI 1.058-1.280; p = 0.0001) were related to subD after adjustment to age, disease duration, daily equivalent levodopa dose, motor status (UPDRS-III), and living alone. Conclusions: SubD is a frequent problem in patients with PD and is more prevalent in these patients than in controls. QoL is worse and non-motor symptoms burden is greater in subD PD patients.

Published
2020

4. Estudio retrospectivo de la efectividad de la lamotrigina en monoterapia para el tratamiento de crisis epilépticas. Estudio ERELMO

Author

S Cobaleda, M Fernández, F J Vadillo-Olmo, O Vega-López, M C Díaz, J M Paz-González, José Ángel Mauri-Llerda, Javier Salas-Puig, Grupo de Investigadores del Estudio Erelmo, D Campos, and M D Morales-Martínez

Subjects
Gynecology, medicine.medical_specialty, Multicenter study, business.industry, Medicine, Neurology (clinical), General Medicine, business
Abstract

Introduccion. La eficacia y la tolerabilidad de la lamotrigina (LTG), tanto en monoterapia como en politerapia, se han demostrado en ensayos clinicos. El objetivo del estudio ERELMO fue evaluar retrospectivamente la efectividad y la seguridad de la LTG en monoterapia en el control de crisis epilepticas en condiciones de uso clinico habitual en Espana. Pacientes y metodos. Se selecciono a 446 pacientes que recibieron tratamiento con LTG en los 12 meses previos a la inclusion en el estudio. Las principales variables estudiadas fueron la efectividad (disminucion al menos de un 50% en el numero de crisis, mejoria en el control de crisis mensuales y pacientes libres de crisis a los 2, 6 y 12 meses) y la seguridad (efectos adversos y retiradas del tratamiento). Resultados. Se evaluaron 446 historias clinicas (edad media: 41 anos; 57,8% mujeres). La LTG en monoterapia (dosis media: 217,2 mg/dia) produjo una disminucion de la media de crisis respecto al valor basal en los diferentes periodos de estudio (2, 6, 12 meses; p < 0,0001). Al finalizar el estudio, un 77% de pacientes estaba libre de crisis epilepticas. Se encontro perdida de efectividad de la LTG en el 8,5% de los pacientes. El 15% de los pacientes presento efectos adversos, los mas frecuentes de los cuales fueron insomnio, somnolencia, cefalea y erupcion cutanea. Al finalizar el estudio, el 88,8% de los pacientes continuaba en tratamiento con LTG en monoterapia. Conclusion. El presente estudio avala la utilizacion de LTG en monoterapia debido a su efectividad y buena tolerabilidad, que facilitan el cumplimiento del tratamiento en condiciones de uso clinico habitual en pacientes con epilepsia.

Published
2008
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