Optimizing dopaminergic therapy in the most severe stages of Parkinson's disease can reduce non-motor symptoms and improve quality of life, these Lund University scientists report in the Journal of Parkinson's Disease. Non-motor symptoms common in advanced stages, as their frequency and severity increase with disease progression.
While Parkinson's disease is generally considered a disease that affects movement, it does indeed involve a large number of non-motor symptoms, which can also impact quality of life. These non-motor symptoms include cognitive impairment, mood disorders and depression, listlessness, daytime sleepiness and other sleep disturbances, fatigue, and autonomic dysfunctions such as urgency, more generally incontinence and erectile dysfunction. The frequency and severity of most of these symptoms increase with disease progression. Previous research has shown that the frequency and severity of non-motor symptoms are the strongest predictors of quality of life in patients with advanced disease.
Advanced Parkinson's, a group of forgotten patients?During the last 4-5 years of the disease, Parkinson's patients “constitute a forgotten group of patients”, explains lead author Dr. Per Odin, professor in the Department of Neurology at Lund University (Sweden). “There are reasons to believe that these advanced patients are being inadequately treated. The effect of dopaminergic treatment may not be as evident in the advanced stage as in the early stage”. The researchers therefore looked particularly at the question of the optimal pharmacological treatment for these advanced-stage patients and in particular evaluated the effect of dopaminergic treatment on non-motor symptoms in 30 patients. The dopaminergic effect on non-motor symptomatology was assessed using different tests. This analysis reveals that:
- non-motor symptoms are indeed more frequent in these patients,
- that many of these symptoms are present in more than 80% of patients;
- the highest scores are observed in the domains of mood, apathy and urinary incontinence.
The researchers stress here the importance of optimizing L-dopa treatment in advanced disease to give patients the best possible quality of life: " We call on our colleagues to be careful that the treatment is well optimized throughout the progression of the disease and in its most severe stages.
Knowing that sufficient dopaminergic therapy can have significant effects on motor and non-motor symptoms in Parkinson's patients can help treating physicians improve the quality of life of their patients, even in advanced stages .
