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Title: Non-motor symptoms in incident Parkinson's disease : a focus on mood and sleep disturbance
Author: Khoo, Tien Kheng
Awarding Body: University of Newcastle Upon Tyne
Current Institution: University of Newcastle upon Tyne
Date of Award: 2012
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Parkinson's disease (PD) is a common neurodegenerative condition with a predilection for the elderly. PD is classically known as a disease of motor debility. However, non-motor symptoms (NMS) in PD are becoming increasingly recognised. Sleep and mood disturbance are commonly encountered as major non-motor issues in clinical practice. These symptoms often cause significant bio-psycho-social impact which can lead to impaired quality of life in the patient and their family. Despite their importance, these symptoms have rarely been studied in incident cohorts of PD. Limited understanding of NMS and their temporal onset was one of the main motivational factors for this study. In addition, there was no prior study of these symptoms in an incident cohort of PD in North East England. This gap in local epidemiological knowledge plus the inherent need to improve our understanding on this subject acted as a catalyst for this project which was executed as part of the Incidence of Cognitive Impairment in a Cohort with Longitudinal Evaluation - Parkinson's Disease (ICICLE-PD) study. The crude incidence of PD in North East England was 17.71 100,000 persons per year. This figure was somewhat higher than most previous studies in the UK. A major finding was the characterisation of NMS onset and frequency in newly diagnosed PD with symptoms of mood and sleep disturbance being prominent. The temporal onset of many NMS, for example mood changes and sleep disturbances, was earlier than motor symptoms, consistent with current pathophysiological models of disease evolution. 28.6% of subjects experienced anxiety and apathy whilst a smaller proportion had symptoms of major depression (13.1%). In terms of sleep disturbance, 56.9% experienced poor sleep quality and excessive daytime somnolence was present in 22.4% of subjects. Almost half the PO cohort (46.0%) had clinically defined REM sleep behaviour disorder. This study confirms the high burden of NMS in incident PD and so the importance of screening for such symptoms in newly diagnosed cases.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available