Abstract Details

Title Meta-Analysis on the Prevalence of Selected Premotor Symptoms of Parkinson Disease before and after Diagnosis

Topic Movement Disorders

Presentation(s) P06 - (-)

Poster/Presentation
Number 097

Objective

Background BACKGROUND: Accumulating evidence suggests that some nonmotor symptoms precede the diagnosis of Parkinson disease (PD).

Design/Methods DESIGN/METHODS: PubMed publications from 1965 through June 2011 were searched for the following key PD PMS: hyposmia, constipation , REM sleep behavior disorder (RBD), excessive daytime sleepiness (EDS), depression, and anxiety. Eligible studies were publications with original data on one or more PMS. For each symptom, we calculated the pooled prevalence and 95% confidence intervals using random-effects models.

Results RESULTS: The search generated a total of 592 publications and 101 met the inclusion criteria. 93 papers provided data on these symptoms after PD diagnosis. For all symptoms, the prevalence was substantially higher in PD cases than controls: hyposmia being the most prevalent (63.7% among cases vs. 12.2% among controls), followed by constipation (50.8% vs. 16.1%), anxiety (39.8% vs. 19.7%), depression (36.5% vs. 11.8%), RBD (32.5% vs. 8.4%), and EDS (29.7% vs. 12.8%). Across studies, we also found a correlation between disease duration and higher prevalence of constipation, EDS, and anxiety. Only 12 studies provided data prior to PD diagnosis. All symptoms were more prevalent among future PD patients than controls prior to diagnosis: 37.5% of cases vs. 19.9% of controls for hyposmia, 25.1% vs. 9.7% for constipation, 24.1% vs. 16.4% for depression, 20.9% vs. 7.7% for EDS, and 10.4% vs. 3.5% for anxiety. The prevalence of RBD among future PD patients was 15.4%, though there was no corresponding data on controls for RBD. However, data on temporal relationship are limited.

Conclusions CONCLUSIONS: This meta-analysis provided summary estimates for the prevalence of key PMS before and after PD diagnosis. More studies are needed to study these symptoms prior to PD motor onset and to understand the temporal relationships.

Authors/Disclosures
PRESENTER	No disclosure on file
Wen Zhang, PhD (Natl Inst of Environmental Health Sciences, Epidemiology Branch)	No disclosure on file
	No disclosure on file
Honglei Chen, MD, PhD, FAAN (Michigan State University)	The institution of Dr. Chen has received research support from NIH, . The institution of Dr. Chen has received research support from DoD. The institution of Dr. Chen has received research support from Parkinson's Foundation. The institution of Dr. Chen has received research support from MSU GE and Gibby vs. Parky project.
Jacob S. Elkins, MD	No disclosure on file

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