Nonmotor symptoms in de novo Parkinson disease before and after dopaminergic treatment

Background: Nonmotor symptoms (NMSs) are common in patients with Parkinson disease (PD), but little is known about the burden of the full range of NMSs in de novo PD patients. Objectives: NMSs in untreated de novo PD patients were evaluated both quantitatively and qualitatively using the Non-Motor Symptoms Assessment Scale (NMSS); the findings were compared to those of control subjects. The effects of dopaminergic treatment on NMSs were also determined. Methods: NMSs were evaluated in 23 patients with untreated de novo PD and 23 healthy controls. The motor section of the Unified Parkinson Disease Rating Scale (mUPDRS) and the Hoehn and Yahr (HY) stage were also checked in the PD patients. The number of NMSs and the NMSS scores of the PD patients were compared with those of the controls. Three months after the start of dopaminergic medication, 16 PD patients were reevaluated with respect to the NMSS and mUPDRS, and the HY stage. Results: The number of NMSs and the NMSS scores were significantly higher in the PD patients than in the controls. The three most prevalent NMSs among the PD patients were 'nocturia,' 'forget things or events,' and 'restless legs.' In the PD group, the number of NMSs was correlated with the HY stage but not with age, disease duration, or mUPDRS score. Follow-up of 16 patients at 3 months after commencing PD medication revealed no changes in either the number of NMSs or the NMSS score, despite improvement in motor symptoms. Conclusions: Untreated de novo PD patients have more nonmotor problems than controls, and these NMSs are not ameliorated by dopaminergic medication. (C) 2009 Elsevier B.V. All rights reserved.