ACMJ

Anatolian Current Medical Journal (ACMJ) is an unbiased, peer-reviewed, and open access international medical journal. The Journal publishes interesting clinical and experimental research conducted in all fields of medicine, interesting case reports, and clinical images, invited reviews, editorials, letters, comments, and related knowledge.

EndNote Style
Index
Original Article
Autonomic symptoms in early-stage Parkinson’s patients and their relationship with cognition and disease parameters
Aims: Autonomic dysfunction is a prevalent feature throughout various stages of the disease and can significantly exacerbate the overall impact of the condition. Moreover, it is linked to accelerated disease advances and diminished vitality rates in individuals with Parkinson’s disease (PD). The main goal of this study is to evaluate the prevalence of autonomic symptoms and cognitive findings and investigate their associations with disease-related factors in early-stage PD patients.
Methods: A total of 49 individuals diagnosed with PD were enrolled in this study. Disease severity was assessed using the Unified Parkinson’s Disease Rating Scale (UPDRS), and the disease stage was determined through the modified Hoehn & Yahr Rating Scale (mHYRS). By the mH&Y scale, only individuals in the early stages (?2.5) of the disease were included in this investigation. The evaluation of autonomic symptoms in PD was conducted using the Scales for Outcomes in Parkinson’s Disease for Autonomic Symptoms (SCOPA-AUT) scale. The cognitive functions of the patients were assessed utilizing the Turkish version of the Montreal Cognitive Assessment Scale (MOCA-TR).
Results: The study included 44% (n=22) females and 56% (n=27) males as participants. The average age was 61.5±10.1 years. The mean SCOPA-AUT score was 18.9±9.36, with the most prevalent autonomic symptoms related to the gastrointestinal system. A positive correlation was shown with autonomic symptoms and disease stages (p=0.024, r=0.322). However, no significant relationship was found between autonomic symptoms, other disease parameters, and cognition. We observed a notable inverse correlation between the disease stage and cognitive status (p=0.003, r=-0.417).
Conclusion: Our study concluded that autonomic dysfunctions manifest from the early stages of Parkinson’s disease and can intensify as the disease progresses. Identifying and addressing these dysfunctions at an early stage would play a pivotal role in lessening the overall impact of the disease.


1. Khoo TK, Yarnall AJ, Duncan GW, et al. The spectrum ofnonmotor symptoms in early Parkinson disease. Neurology.2013;80(3):276-281.
2. Djaldetti R, Lev N, Melamed E. Lesions outside the CNS inParkinson’s disease. Mov Disord. 2009;24(6):793-800.
3. Merola A, Romagnolo A, Comi C, et al. Prevalence and burdenof dysautonomia in advanced Parkinson’s disease. Mov Disord.2017;32(5):796-797.
4. Mendoza-Velásquez JJ, Flores-Vázquez JF, Barrón-Velázquez E,Sosa-Ortiz AL, Illigens BW, Siepmann T. Autonomic dysfunctionin α-synucleinopathies. Front Neurol. 2019;10:363.
5. Siddiqui MF, Rast S, Lynn MJ, Auchus AP, Pfeiffer RF. Autonomicdysfunction in Parkinson’s disease: a comprehensive symptomsurvey. Parkinsonism Relat Disord. 2002;8(4):277-284.
6. Stankovic I, Petrovic I, Pekmezovic T, et al. Longitudinalassessment of autonomic dysfunction in early Parkinson’sdisease. Parkinsonism Relat Disord. 2019;66:74-79.
7. De Pablo-Fernandez E, Tur C, Revesz T, Lees AJ, Holton JL,Warner TT. Association of autonomic dysfunction with diseaseprogression and survival in Parkinson disease. JAMA Neurol.2017;74(8):970-976.
8. Idiaquez J, Benarroch EE, Rosales H, Milla P, Ríos L. Autonomicand cognitive dysfunction in Parkinson’s disease. Clin Auton Res.2007;17(2):93-98
9. Aygun D. , Akpinar C. K. , Yon S. , Onar M. K. Effect of clinicalautonomic dysfunction on cognitive functions in Parkinson’sdisease. Dicle Med J. 2017;44(3):225-231.
10. Postuma RB, Berg D, Stern M, et al. MDS clinical diagnosticcriteria for Parkinson’s disease. Mov Disord. 2015;30(12):1591-1601. doi:10.1002/mds.26424
11. Tomlinson CL, Stowe R, Patel S, Rick C, Gray R, Clarke CE.Systematic review of levodopa dose equivalency reporting inParkinson’s disease. Mov Disord. 2010;25(15):2649-2653.
12. Goetz CG, Poewe W, Rascol O, et al. Movement Disorder SocietyTask Force report on the Hoehn and Yahr staging scale: statusand recommendations. Mov Disord. 2004;19(9):1020-1028.
13. Rodriguez-Blazquez C, Forjaz MJ, Frades-Payo B, de Pedro-Cuesta J, Martinez-Martin P. Longitudinal Parkinson’s diseasepatient study, estudio longitudinal de pacients con enfermedadda Parkinson group. independent validation of the scales foroutcomes in Parkinson’s disease-autonomic (SCOPA-AUT). EurJ Neurol. 2010;17(2):194-201.
14. Ozdilek B, Kenangil G. Validation of the Turkish version of theMontreal cognitive assessment scale (MoCA-TR) in patientswith Parkinson’s disease. Clin Neuropsychol. 2014;28(2):333-343.
15. Parkinson J. An essay on the shakıng palsy. Arch Neurol.1969;20(4):441-445.
16. den Hartog Jager Wa, Bethlem J. The distribution of Lewy bodiesin the central and autonomic nervous systems in idiopathicparalysis agitans. J Neurol Neurosurg Psychiatry. 1960;23(4):283-290.
17. Iwanaga K, Wakabayashi K, Yoshimoto M, et al. Lewy body-typedegeneration in cardiac plexus in Parkinson’s and incidentalLewy body diseases. Neurology. 1999;52(6):1269-1271.
18. Sung HY, Park JW, Kim JS. The frequency and severity ofgastrointestinal symptoms in patients with early Parkinson’sdisease. J Mov Disord. 2014;7(1):7-12.
19. Verbaan D, Marinus J, Visser M, van Rooden SM, StiggelboutAM, van Hilten JJ. Patient-reported autonomic symptoms inParkinson disease. Neurology. 2007;69(4):333-341.
20. Arı S, Candan F, Işık N, Öztop Ö, Aydın Cantürk İ, Arıcı DüzÖ. Autonomic symptoms in idiopathic Parkinson’s disease.Cumhuriyet Med J. 2014;36(3):344-349
21. Zadikoff C, Fox SH, Tang-Wai DF, et al. A comparison of themini mental state exam to the Montreal cognitive assessment inidentifying cognitive deficits in Parkinson’s disease. Mov Disord.2008;23(2):297-299.
Volume 5, Issue 4, 2023
Page : 498-502
_Footer