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Prevalence and duration of non‐motor symptoms in prodromal Parkinson's disease

Lookup NU author(s): Dr Rory Durcan, Dr Lou Wiblin, Dr Rachael LawsonORCiD, Dr Tien Kheng Khoo, Professor Alison Yarnall, Dr Gordon Duncan, Professor David BrooksORCiD, Professor Nicola PaveseORCiD, Professor David Burn



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


© 2019 The Authors. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology Background and purpose: The prevalence and duration of non-motor symptoms (NMS) in prodromal Parkinson's disease (PD) has not been extensively studied. The aim of this study was to determine the prevalence and duration of prodromal NMS (pNMS) in a cohort of patients with recently diagnosed PD. Methods: We evaluated the prevalence and duration of pNMS in patients with early PD (n = 154). NMS were screened for using the Non-Motor Symptom Questionnaire (NMSQuest). We subtracted the duration of the presence of each individual NMS reported from the duration of the earliest motor symptom. NMS whose duration preceded the duration of motor symptoms were considered a pNMS. Individual pNMS were then grouped into relevant pNMS clusters based on the NMSQuest domains. Motor subtypes were defined as tremor dominant, postural instability gait difficulty (PIGD) and indeterminate type according to the Movement Disorder Society Unified Parkinson's Disease Rating Scale revision. Results: Prodromal NMS were experienced by 90.3% of patients with PD and the median number experienced was 4 (interquartile range, 2–7). A gender difference existed in the pNMS experienced, with males reporting more sexual dysfunction, forgetfulness and dream re-enactment, whereas females reported more unexplained weight change and anxiety. There was a significant association between any prodromal gastrointestinal symptoms [odds ratio (OR), 2.30; 95% confidence interval (CI), 1.08–4.89, P = 0.03] and urinary symptoms (OR, 2.54; 95% CI, 1.19–5.35, P = 0.016) and the PIGD phenotype. Further analysis revealed that total pNMS were not significantly associated with the PIGD phenotype (OR, 1.10; 95% CI, 0.99–1.21, P = 0.068). Conclusions: Prodromal NMS are common and a gender difference in pNMS experienced in prodromal PD may exist. The PIGD phenotype had a higher prevalence of prodromal gastrointestinal and urinary tract symptoms.

Publication metadata

Author(s): Durcan R, Wiblin L, Lawson RA, Khoo TK, Yarnall AJ, Duncan GW, Brooks DJ, Pavese N, Burn DJ

Publication type: Article

Publication status: Published

Journal: European Journal of Neurology

Year: 2019

Volume: 26

Issue: 7

Pages: 979-985

Print publication date: 05/06/2019

Online publication date: 31/01/2019

Acceptance date: 22/01/2019

Date deposited: 23/01/2019

ISSN (print): 1351-5101

ISSN (electronic): 1468-1331

Publisher: Blackwell Publishing Ltd


DOI: 10.1111/ene.13919


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Funder referenceFunder name
Lockhart Parkinson's Disease Research Fund
J-0802Parkinson`s UK (formerly Parkinson`s Disease Society)
Newcastle upon Tyne Hospitals NHS Foundation Trust
The UK NIHR Biomedical Research Centre for Ageing