Top

Published in:

Open Access 01-12-2021 | Parkinson's Disease | Research

Prevalence and profile of nocturnal disturbances in Chinese patients with advanced-stage Parkinson’s disease: a cross-sectional epidemiology study

Authors: Guiying He, Chun-Feng Liu, Qinyong Ye, Zhenguo Liu, Miao Jin, Huifang Shang, Ling Chen, Houzhen Tuo, Hong Jiang, Jifu Cai, Kalpesh Joshi, James Cooper, Lu Zi, Shengdi Chen

Published in: BMC Neurology | Issue 1/2021

Abstract

Background

The impact of nocturnal disturbance (ND) in Parkinson’s disease on quality of life of patients in Western Countries is increasingly understood. Our study aimed to investigate ND prevalence and its quality of life impact in patients with advanced Parkinson’s disease in China.

Methods

In a multicenter, tertiary-care hospital, outpatient-based, cross-sectional study, patients with advanced Parkinson’s disease (Modified Hoehn & Yahr [H&Y] Stage II–IV with ≥3 h awake “off” time/day) from 10 tertiary hospitals throughout China completed the Parkinson’s Disease Sleep Scale-2 (PDSS-2) and Parkinson’s Disease Questionnaire-39 (PDQ-39). The primary endpoint was the percentage of patients with significant ND (PDSS-2 total score ≥ 15). Additional endpoints were demographic and clinical characteristics, PDSS-2 and PDQ-39 total and subscale scores, correlation between PDSS-2 and PDQ-39, and risk factors for ND and higher PDSS-2 or PDQ-39 scores.

Results

Of 448 patients analyzed (mean age 63.5 years, 47.3% female), 70.92% (95% confidence interval: 66.71, 75.13) had significant ND. Presence of ND and higher PDSS-2 scores were associated with longer disease duration and higher H&Y stage. Presence of ND was also associated with more awake “off” time/day and female sex. PDQ-39 scores were significantly worse for patients with ND versus those without ND; worse scores were associated with more awake “off” time/day, female sex, and higher H&Y stage. PDSS-2 and PDQ-39 total scores were associated: Pearson correlation coefficient 0.62 (p < 0.001).

Conclusions

In China, ND was highly prevalent in patients with advanced Parkinson’s disease and adversely impacted quality of life. This study highlights the importance of early diagnosis and optimized management of ND in patients with Parkinson’s disease in China.

Available only for authorised users

Grandas F, Iranzo A. Nocturnal problems occurring in Parkinson’s disease. Neurology. 2004;63(8 Suppl 3):S8–S11. https://doi.org/10.1212/wnl.63.8_suppl_3.s8.CrossRefPubMed

Hermanowicz N, Jones SA, Hauser RA. Impact of non-motor symptoms in Parkinson's disease: a PMDAlliance survey. Neuropsychiatr Dis Treat. 2019;15:2205–12. https://doi.org/10.2147/NDT.S213917.CrossRefPubMedPubMedCentral

Barone P, Amboni M, Vitale C, Bonavita V. Treatment of nocturnal disturbances and excessive daytime sleepiness in Parkinson's disease. Neurology. 2004;63(8 Suppl 3):S35–S8. https://doi.org/10.1212/wnl.63.8_suppl_3.s35.CrossRefPubMed

Liu CF, Wang T, Zhan SQ, Geng DQ, Wang J, Liu J, et al. Management recommendations on sleep disturbance of patients with Parkinson's disease. Chin Med J. 2018;131(24):2976–85. https://doi.org/10.4103/0366-6999.247210.CrossRefPubMed

Kumar S, Bhatia M, Behari M. Sleep disorders in Parkinson’s disease. Mov Disord. 2002;17(4):775–81. https://doi.org/10.1002/mds.10167.CrossRefPubMed

Politis M, Wu K, Molloy S, Bain PG, Chaudhuri KR, Piccini P. Parkinson’s disease symptoms: the patient’s perspective. Mov Disord. 2010;25(11):1646–51. https://doi.org/10.1002/mds.23135.CrossRefPubMed

Willison LD, Kudo T, Loh DH, Kuljis D, Colwell CS. Circadian dysfunction may be a key component of the non-motor symptoms of Parkinson's disease: insights from a transgenic mouse model. Exp Neurol. 2013;243:57–66. https://doi.org/10.1016/j.expneurol.2013.01.014.CrossRefPubMedPubMedCentral

Chaudhuri KR, Pal S, DiMarco A, Whately-Smith C, Bridgman K, Mathew R, et al. The Parkinson’s disease sleep scale: a new instrument for assessing sleep and nocturnal disability in Parkinson's disease. J Neurol Neurosurg Psychiatry. 2002;73(6):629–35. https://doi.org/10.1136/jnnp.73.6.629.CrossRefPubMedPubMedCentral

Hogl B, Arnulf I, Comella C, Ferreira J, Iranzo A, Tilley B, et al. Scales to assess sleep impairment in Parkinson's disease: critique and recommendations. Mov Disord. 2010;25(16):2704–16. https://doi.org/10.1002/mds.23190.CrossRefPubMed

10.

Peto V, Jenkinson C, Fitzpatrick R, Greenhall R. The development and validation of a short measure of functioning and well being for individuals with Parkinson’s disease. Qual Life Res. 1995;4(3):241–8. https://doi.org/10.1007/bf02260863.CrossRefPubMed

11.

Tsang KL, Chi I, Ho SL, Lou VW, Lee TM, Chu LW. Translation and validation of the standard Chinese version of PDQ-39: a quality-of-life measure for patients with Parkinson’s disease. Mov Disord. 2002;17(5):1036–40. https://doi.org/10.1002/mds.10249.CrossRefPubMed

12.

Luo W, Gui XH, Wang B, Zhang WY, Ouyang ZY, Guo Y, et al. Validity and reliability testing of the Chinese (mainland) version of the 39-item Parkinson's disease questionnaire (PDQ-39). J Zhejiang Univ Sci B. 2010;11(7):531–8. https://doi.org/10.1631/jzus.B0900380.CrossRefPubMedPubMedCentral

13.

Wang G, Cheng Q, Zeng J, Bai L, Liu GD, Zhang Y, et al. Sleep disorders in Chinese patients with Parkinson's disease: validation study of a Chinese version of Parkinson’s disease sleep scale. J Neurol Sci. 2008;271(1–2):153–7. https://doi.org/10.1016/j.jns.2008.04.008.CrossRefPubMed

14.

Trenkwalder C, Kohnen R, Hogl B, Metta V, Sixel-Doring F, Frauscher B, et al. Parkinson’s disease sleep scale--validation of the revised version PDSS-2. Mov Disord. 2011;26(4):644–52. https://doi.org/10.1002/mds.23476.CrossRefPubMed

15.

Trenkwalder C, Kies B, Rudzinska M, Fine J, Nikl J, Honczarenko K, et al. Rotigotine effects on early morning motor function and sleep in Parkinson's disease: a double-blind, randomized, placebo-controlled study (RECOVER). Mov Disord. 2011;26(1):90–9. https://doi.org/10.1002/mds.23441.CrossRefPubMed

16.

Liu H, Ou R, Wei Q, Hou Y, Cao B, Zhao B, et al. Rapid eye movement behavior disorder in drug-naive patients with Parkinson's disease. J Clin Neurosci. 2019;59:254–8. https://doi.org/10.1016/j.jocn.2018.07.007.CrossRefPubMed

17.

Zhang ZX, Liu CF, Tao EX, Shao M, Liu YM, Wang J, et al. Rotigotine transdermal patch in Chinese patients with advanced Parkinson's disease: a randomized, double-blind, placebo-controlled pivotal study. Parkinsonism Relat Disord. 2017;44:6–12. https://doi.org/10.1016/j.parkreldis.2017.08.015.CrossRefPubMed

18.

Chang CW, Fan JY, Chang BL, Wu YR. Anxiety and levodopa equivalent daily dose are potential predictors of sleep quality in patients with Parkinson disease in Taiwan. Front Neurol. 2019;10:340. https://doi.org/10.3389/fneur.2019.00340.CrossRefPubMedPubMedCentral

19.

Martinez-Martin P, Wetmore JB, Rodríguez-Blázquez C, Arakaki T, Bernal O, Campos-Arillo V, et al. The Parkinson's disease sleep Scale-2 (PDSS-2): validation of the Spanish version and its relationship with a roommate-based version. Mov Disord Clin Pract. 2019;6(4):294–301. https://doi.org/10.1002/mdc3.12749.CrossRefPubMedPubMedCentral

20.

Melka D, Tafesse A, Bower JH, Assefa D. Prevalence of sleep disorders in Parkinson’s disease patients in two neurology referral hospitals in Ethiopia. BMC Neurol. 2019;19(1):205. https://doi.org/10.1186/s12883-019-1431-2.CrossRefPubMedPubMedCentral

21.

Cerri S, Mus L, Blandini F. Parkinson’s disease in women and men: What’s the difference? J Parkinsons Dis. 2019;9(3):501–15. https://doi.org/10.3233/jpd-191683.CrossRefPubMedPubMedCentral

22.

Chen K, Yang YJ, Liu FT, Li DK, Bu LL, Yang K, et al. Evaluation of PDQ-8 and its relationship with PDQ-39 in China: a three-year longitudinal study. Health Qual Life Outcomes. 2017;15(1):170. https://doi.org/10.1186/s12955-017-0742-5.CrossRefPubMedPubMedCentral

23.

Hu T, Ou R, Liu H, Hou Y, Wei Q, Song W, et al. Gender and onset age related-differences of non-motor symptoms and quality of life in drug-naïve Parkinson's disease. Clin Neurol Neurosurg. 2018;175:124–9. https://doi.org/10.1016/j.clineuro.2018.11.001.CrossRefPubMed

24.

Wooten GF, Currie LJ, Bovbjerg VE, Lee JK, Patrie J. Are men at greater risk for Parkinson's disease than women? J Neurol Neurosurg Psychiatry. 2004;75(4):637–9. https://doi.org/10.1136/jnnp.2003.020982.CrossRefPubMedPubMedCentral

25.

Ma CL, Su L, Xie JJ, Long JX, Wu P, Gu L. The prevalence and incidence of Parkinson's disease in China: a systematic review and meta-analysis. J Neural Transm (Vienna). 2014;121(2):123–34. https://doi.org/10.1007/s00702-013-1092-z.CrossRef

26.

G. B. D. Parkinson’s Disease Collaborators. Global, regional, and national burden of Parkinson’s disease, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol. 2018;17(11):939–53. https://doi.org/10.1016/S1474-4422(18)30295-3.CrossRef

27.

Shen Y, Liu CF. Sleep disorders in Parkinson's disease: present status and future prospects. Chin Med J. 2018;131(8):883–5. https://doi.org/10.4103/0366-6999.229903.CrossRefPubMed

28.

Li G, Ma J, Cui S, He Y, Xiao Q, Liu J, et al. Parkinson's disease in China: a forty-year growing track of bedside work. Transl Neurodegener. 2019;8:22. https://doi.org/10.1186/s40035-019-0162-z.CrossRefPubMedPubMedCentral

29.

Wang T, Zeng R. Addressing inequalities in China's health service. Lancet. 2015;386(10002):1441. https://doi.org/10.1016/S0140-6736(15)00402-X.CrossRefPubMed

30.

Suzuki K, Miyamoto T, Miyamoto M, Suzuki S, Numao A, Watanabe Y, et al. Evaluation of cutoff scores for the Parkinson's disease sleep scale-2. Acta Neurol Scand. 2015;131(6):426–30. https://doi.org/10.1111/ane.12347.CrossRefPubMed

31.

Zhang Y, Zhao JH, Huang DY, Chen W, Yuan CX, Jin LR, et al. Multiple comorbid sleep disorders adversely affect quality of life in Parkinson’s disease patients. NPJ Parkinsons Dis. 2020;6:25. https://doi.org/10.1038/s41531-020-00126-x.CrossRefPubMedPubMedCentral

32.

Chen S, Chan P, Sun S, Chen H, Zhang B, Le W, et al. The recommendations of Chinese Parkinson’s disease and movement disorder society consensus on therapeutic management of Parkinson’s disease. Transl Neurodegener. 2016;5:12. https://doi.org/10.1186/s40035-016-0059-z.CrossRefPubMedPubMedCentral

33.

Jasti DB, Mallipeddi S, Apparao A, Vengamma B, Kolli S, Mohan A. Quality of sleep and sleep disorders in patients with parkinsonism: a polysomnography based study from rural South India. J Neurosci Rural Pract. 2018;9(1):92–9. https://doi.org/10.4103/jnrp.jnrp_189_17.CrossRefPubMedPubMedCentral

34.

Horvath K, Aschermann Z, Acs P, Deli G, Janszky J, Komoly S, et al. Minimal clinically important difference on Parkinson’s disease sleep scale 2nd version. Parkinsons Dis. 2015;2015:970534. https://doi.org/10.1155/2015/970534.CrossRefPubMedPubMedCentral

35.

Le Y, Ren J, Shen J, Li T, Zhang CF. The changing gender differences in life expectancy in Chinese cities 2005–2010. PLoS One. 2015;10(4):e0123320. https://doi.org/10.1371/journal.pone.0123320.CrossRefPubMedPubMedCentral

36.

Horvath K, Aschermann Z, Kovacs M, Makkos A, Harmat M, Janszky J, et al. Changes in quality of life in Parkinson’s disease: how large must they be to be relevant? Neuroepidemiology. 2017;48(1–2):1–8. https://doi.org/10.1159/000455863.CrossRefPubMed

37.

Postuma RB, Berg D, Stern M, Poewe W, Olanow CW, Oertel W, et al. MDS clinical diagnostic criteria for Parkinson's disease. Mov Disord. 2015;30(12):1591–601. https://doi.org/10.1002/mds.26424.CrossRefPubMed

38.

Li J, Jin M, Wang L, Qin B, Wang K. MDS clinical diagnostic criteria for Parkinson’s disease in China. J Neurol. 2017;264(3):476–81. https://doi.org/10.1007/s00415-016-8370-2.CrossRefPubMed

Title: Prevalence and profile of nocturnal disturbances in Chinese patients with advanced-stage Parkinson’s disease: a cross-sectional epidemiology study
Authors: Guiying He
Chun-Feng Liu
Qinyong Ye
Zhenguo Liu
Miao Jin
Huifang Shang
Ling Chen
Houzhen Tuo
Hong Jiang
Jifu Cai
Kalpesh Joshi
James Cooper
Lu Zi
Shengdi Chen
Publication date: 01-12-2021
Publisher: BioMed Central
Keyword: Parkinson's Disease
Published in: BMC Neurology / Issue 1/2021
Electronic ISSN: 1471-2377
DOI: https://doi.org/10.1186/s12883-021-02217-5

2024 ASCO Annual Meeting

Springer Medicine

Prevalence and profile of nocturnal disturbances in Chinese patients with advanced-stage Parkinson’s disease: a cross-sectional epidemiology study

Abstract

Background

Methods

Results

Conclusions

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2021

Effect of antiretroviral treatment on blood-brain barrier integrity in HIV-1 infection

Exacerbation of myopathy triggered by antiobesity drugs in a patient with multiple acyl-CoA dehydrogenase deficiency

Retinal microvascular parameters are not significantly associated with mild cognitive impairment in the Northern Ireland Cohort for the Longitudinal Study of Ageing

Development and validation of the disease - specific problems questionnaire for patients with multiple sclerosis

Innumerable cerebral microbleeds in hepatitis B virus-related decompensated liver cirrhosis: a case report

Feasibility of low-dose dexmedetomidine for prevention of postoperative delirium after intracranial operations: a pilot randomized controlled trial