Cross-sectional analysis of the Parkinson's disease Non-motor International Longitudinal Study baseline non-motor characteristics, geographical distribution and impact on quality of life

Growing evidence suggests that non-motor symptoms (NMS) in Parkinson's disease (PD) have differential progression patterns that have a different natural history from motor progression and may be geographically influenced. We conducted a cross-sectional analysis of 1607 PD patients of whom 1327 were from Europe, 208 from the Americas, and 72 from Asia. The primary objective was to assess baseline non-motor burden, defined by Non-Motor Symptoms Scale (NMSS) total scores. Other aims included identifying the factors predicting quality of life, differences in non-motor burden between drug-naive and non-drug-naive treated patients, and non-motor phenotypes across different geographical locations. Mean age was 65.9 +/- 10.8 years, mean disease duration 6.3 +/- 5.6 years, median Hoehn and Yahr stage was 2 (2-3), and 64.2% were male. In this cohort, mean NMSS scores were 46.7 +/- 37.2. Differences in non-motor burden and patterns differed significantly between drug-naive participants, those with a disease duration of less than five years, and those with a duration of five years or over (p <= 0.018). Significant differences were observed in geographical distribution (NMSS Europe: 46.4 +/- 36.3; Americas: 55.3 +/- 42.8; Asia: 26.6 +/- 25.1; p<0.001), with differences in sleep/fatigue, urinary, sexual, and miscellaneous domains (p0.020). The best predictor of quality of life was the mood/apathy domain (beta =0.308, p<0.001). This global study reveals that while non-motor symptoms are globally present with severe NMS burden impacting quality of life in PD, there appear to be differences depending on disease duration and geographical distribution.

Automated summary

Evidence suggests that non-motor symptoms in Parkinson's disease have different progression patterns influenced by geography, impacting quality of life. Mood/apathy is the most significant factor affecting quality of life.