Shaping the course of early-onset Parkinson's disease: insights from a longitudinal cohort.

Autor: Bovenzi R; Unit of Neurology, Department of Systems Medicine, University of Rome 'Tor Vergata', Via Montpellier, 00133, Rome, Italy., Conti M; Unit of Neurology, Department of Systems Medicine, University of Rome 'Tor Vergata', Via Montpellier, 00133, Rome, Italy., Degoli GR; Unit of Neurology, Department of Systems Medicine, University of Rome 'Tor Vergata', Via Montpellier, 00133, Rome, Italy., Cerroni R; Unit of Neurology, Department of Systems Medicine, University of Rome 'Tor Vergata', Via Montpellier, 00133, Rome, Italy., Simonetta C; Unit of Neurology, Department of Systems Medicine, University of Rome 'Tor Vergata', Via Montpellier, 00133, Rome, Italy., Liguori C; Unit of Neurology, Department of Systems Medicine, University of Rome 'Tor Vergata', Via Montpellier, 00133, Rome, Italy., Salimei C; Unit of Neurology, Department of Systems Medicine, University of Rome 'Tor Vergata', Via Montpellier, 00133, Rome, Italy., Pisani A; Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy.; IRCCS Mondino Foundation, Pavia, Italy., Pierantozzi M; Unit of Neurology, Department of Systems Medicine, University of Rome 'Tor Vergata', Via Montpellier, 00133, Rome, Italy., Stefani A; Unit of Neurology, Department of Systems Medicine, University of Rome 'Tor Vergata', Via Montpellier, 00133, Rome, Italy.; UOSD Parkinson Centre, Tor Vergata University Hospital, Rome, Italy., Mercuri NB; Unit of Neurology, Department of Systems Medicine, University of Rome 'Tor Vergata', Via Montpellier, 00133, Rome, Italy.; IRCCS Fondazione Santa Lucia, European Centre for Brain Research, Rome, Italy., Schirinzi T; Unit of Neurology, Department of Systems Medicine, University of Rome 'Tor Vergata', Via Montpellier, 00133, Rome, Italy. t.schirinzi@yahoo.com.
Jazyk: angličtina
Zdroj: Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology [Neurol Sci] 2023 Sep; Vol. 44 (9), pp. 3151-3159. Date of Electronic Publication: 2023 May 04.
DOI: 10.1007/s10072-023-06826-5
Abstrakt: Introduction: Early -onset Parkinson's disease (EOPD) labels those cases with onset earlier than fifty. Although peculiarities emerged either in clinical or pathological features, EOPD is managed alike typical, late-onset PD. A customized approach would be, instead, better appropriate. Accordingly, a deeper characterization of the clinical course, with an estimation of the disease progression rate, the therapy flow, and the main motor and non-motor complications occurrence, is needed.
Methods: A longitudinal cohort of 193 EOPD patients (selected on a single-centre population of 2000 PD cases) was retrospectively analysed, providing descriptive statics on a series of clinical parameters (genetics, phenotype, comorbidities, therapies, motor and non-motor complications, marital and gender issues) and modelling the trajectories from diagnosis to 10 years later of both Hoehn and Yahr (H&Y) stage and levodopa equivalent daily dose (LEDD).
Results: EOPD had a prevalence of 9.7%, including few monogenic cases. It mostly appeared as a motor syndrome, with asymmetric, rigid-akinetic presentation. H&Y linearly progressed with an increment of 0.92 points/10 years; LEDD flow had a non-linear trend, increasing of 526.90 mg/day in 0-5 years, and 166.83 mg/day in 5-10 years. Motor fluctuations started 6.5 ± 3.2 years from onset, affecting up to 80% of the cohort. Neuropsychiatric troubles interested the 50%, sexual complaints the 12%. Gender-specific motor disturbances emerged.
Conclusion: We shaped EOPD course, modelling a "brain-first" PD subtype, slowly progressive, with non-linear dopaminergic requirement. Major burden mostly resulted from motor fluctuations, neuropsychiatric complications, sexual and marital complaints, with a considerable gender-effect.
(© 2023. The Author(s).)
Databáze: MEDLINE
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