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Santos-García D, Castro ES, de Deus Fonticoba T, Panceiras MJF, Enriquez JGM, González JMP, Bartolomé CC, Planellas LL, Caldentey JG, Caballol N, Legarda I, López IC, Manzanares LL, Rivera MAÁ, Catalán MJ, Nogueira V, Borrué C, Sauco MÁ, Vela L, Cubo E, Castrillo JCM, Alonso PS, Losada MGA, Ariztegui NL, Gastón MI, Kulisevsky J, Pagonabarraga J, Seijo M, Martínez JR, Valero C, Kurtis M, Ardura JG, Prieto C, Mir P, Martinez-Martin P. Sleep Problems Are Related to a Worse Quality of Life and a Greater Non-Motor Symptoms Burden in Parkinson's Disease. J Geriatr Psychiatry Neurol 2021; 34:642-658. [PMID: 33043810 DOI: 10.1177/0891988720964250] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
INTRODUCTION The aim of the present study was to examine the frequency of self-reported sleep problems and their associated factors in a large cohort of PD patients. METHODS PD patients and controls, recruited from 35 centers of Spain from the COPPADIS cohort were included in this cross-sectional study. Sleep problems were assessed by the Spanish version of the Parkinson's disease Sleep Scale version 1 (PDSS-1). An overall score below 82 or a score below 5 on at least 1 item was defined as sleep problems. RESULTS The frequency of sleep problems was nearly double in PD patients compared to controls: 65.8% (448/681) vs 33.5% (65/206) (p < 0.0001). Mean total PDSS score was lower in PD patients than controls: 114.9 ± 28.8 vs 132.8 ± 16.3 (p < 0.0001). Quality of life (QoL) was worse in PD patients with sleep problems compared to those without: PDQ-39SI, 19.3 ± 14 vs 13 ± 11.6 (p < 0.0001); EUROHIS-QoL8, 3.7 ± 0.5 vs 3.9 ± 0.5 (p < 0.0001). Non-motor symptoms burden (NMSS; OR = 1.029; 95%CI 1.015-1.043; p < 0.0001) and impulse control behaviors (QUIP-RS; OR = 1.054; 95%CI 1.009-1.101; p = 0.018) were associated with sleep problems after adjustment for age, gender, disease duration, daily equivalent levodopa dose, H&Y, UPDRS-III, UPDRS-IV, PD-CRS, BDI-II, NPI, VAS-Pain, VAFS, FOGQ, and total number of non-antiparkinsonian treatments. CONCLUSION Sleep problems were frequent in PD patients and were related to both a worse QoL and a greater non-motor symptoms burden in PD. These findings call for increased awareness of sleep problems in PD patients.
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Affiliation(s)
| | - E Suárez Castro
- Hospital Arquitecto Marcide y Hospital Naval, Complejo Hospitalario Universitario de Ferrol (CHUF), Ferrol, A Coruña, Spain
| | - T de Deus Fonticoba
- Hospital Arquitecto Marcide y Hospital Naval, Complejo Hospitalario Universitario de Ferrol (CHUF), Ferrol, A Coruña, Spain
| | | | | | - J M Paz González
- CHUAC, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain
| | - C Cores Bartolomé
- CHUAC, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain
| | | | | | - N Caballol
- Consorci Sanitari Integral, Hospital Moisés Broggi, Sant Joan Despí, Barcelona, Spain
| | - I Legarda
- Hospital Universitario Son Espases, Palma de Mallorca, Spain
| | - I Cabo López
- Complejo Hospitalario Universitario de Pontevedra (CHOP), Pontevedra, Spain
| | | | - M A Ávila Rivera
- Consorci Sanitari Integral, Hospital General de L´Hospitalet, L´Hospitalet de Llobregat, Barcelona, Spain
| | - M J Catalán
- Hospital Universitario Clínico San Carlos, Madrid, Spain
| | - V Nogueira
- Hospital Da Costa de Burela, Lugo, Spain
| | - C Borrué
- Hospital Infanta Sofía, Madrid, Spain
| | | | - L Vela
- Fundación Hospital de Alcorcón, Madrid, Spain
| | - E Cubo
- Complejo Asistencial Universitario de Burgos, Burgos, Spain
| | | | | | - M G Alonso Losada
- Hospital Álvaro Cunqueiro, Complejo Hospitalario Universitario de Vigo (CHUVI), Vigo, Spain
| | | | - M I Gastón
- Complejo Hospitalario de Navarra, Pamplona, Spain
| | | | | | - M Seijo
- Complejo Hospitalario Universitario de Pontevedra (CHOP), Pontevedra, Spain
| | | | - C Valero
- Hospital Arnau de Vilanova, Valencia, Spain
| | - M Kurtis
- Hospital Ruber Internacional, Madrid, Spain
| | | | - C Prieto
- Hospital Rey Juan Carlos, Madrid, Spain
| | - P Mir
- Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Spain.,Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - P Martinez-Martin
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
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Santos-García D, de Deus Fonticoba T, Suárez Castro E, Aneiros Díaz A, Cores Bartolomé C, Feal Panceiras MJ, Paz González JM, Valdés Aymerich L, García Moreno JM, Blázquez Estrada M, Jesús S, Mir P, Aguilar M, Planellas LL, García Caldentey J, Caballol N, Legarda I, Cabo López I, López Manzanares L, Ávila Rivera MA, Catalán MJ, López Díaz LM, Borrué C, Álvarez Sauco M, Vela L, Cubo E, Martínez Castrillo JC, Sánchez Alonso P, Alonso Losada MG, López Ariztegui N, Gastón I, Pascual-Sedano B, Seijo M, Ruíz Martínez J, Valero C, Kurtis M, González Ardura J, Prieto Jurczynska C, Martinez-Martin P. Quality of life and non-motor symptoms in Parkinson's disease patients with subthreshold depression. J Neurol Sci 2020; 418:117109. [PMID: 32927370 DOI: 10.1016/j.jns.2020.117109] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 06/30/2020] [Accepted: 08/24/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND The role of subthreshold depression (subD) in Parkinson's Disease (PD) is not clear. The present study aimed to compare the quality of life (QoL) in PD patients with subD vs patients with no depressive disorder (nonD). Factors related to subD were identified. MATERIAL AND METHODS PD patients and controls recruited from the COPPADIS cohort were included. SubD was defined as Judd criteria. The 39-item Parkinson's disease Questionnaire (PDQ-39) and the EUROHIS-QOL 8-item index (EUROHIS-QOL8) were used to assess QoL. RESULTS The frequency of depressive symptoms was higher in PD patients (n = 694) than in controls (n = 207) (p < 0.0001): major depression, 16.1% vs 7.8%; minor depression, 16.7% vs 7.3%; subD, 17.4% vs 5.8%. Both health-related QoL (PDQ-39; 18.1 ± 12.8 vs 11.6 ± 10; p < 0.0001) and global QoL (EUROHIS-QOL8; 3.7 ± 0.5 vs 4 ± 0.5; p < 0.0001) were significantly worse in subD (n = 120) than nonD (n = 348) PD patients. Non-motor Symptoms Scale (NMSS) total score was higher in subD patients (45.9 ± 32 vs 29.1 ± 25.8;p < 0.0001). Non-motor symptoms burden (NMSS;OR = 1.019;95%CI 1.011-1.028; p < 0.0001), neuropsychiatric symptoms (NPI; OR = 1.091; 95%CI 1.045-1.139; p < 0.0001), impulse control behaviors (QUIP-RS; OR = 1.035; 95%CI 1.007-1063; p = 0.013), quality of sleep (PDSS; OR = 0.991; 95%CI 0.983-0.999; p = 0.042), and fatigue (VAFS-physical; OR = 1.185; 95%CI 1.086-1.293; p < 0.0001; VAFS-mental; OR = 1.164; 95%CI 1.058-1.280; p = 0.0001) were related to subD after adjustment to age, disease duration, daily equivalent levodopa dose, motor status (UPDRS-III), and living alone. CONCLUSIONS SubD is a frequent problem in patients with PD and is more prevalent in these patients than in controls. QoL is worse and non-motor symptoms burden is greater in subD PD patients.
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Affiliation(s)
- D Santos-García
- CHUAC, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain.
| | - T de Deus Fonticoba
- Hospital Arquitecto Marcide y Hospital Naval, Complejo Hospitalario Universitario de Ferrol (CHUF), Ferrol, A Coruña, Spain
| | - E Suárez Castro
- Hospital Arquitecto Marcide y Hospital Naval, Complejo Hospitalario Universitario de Ferrol (CHUF), Ferrol, A Coruña, Spain
| | - A Aneiros Díaz
- Hospital Arquitecto Marcide y Hospital Naval, Complejo Hospitalario Universitario de Ferrol (CHUF), Ferrol, A Coruña, Spain
| | - C Cores Bartolomé
- CHUAC, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain
| | | | - J M Paz González
- CHUAC, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain
| | - L Valdés Aymerich
- CHUAC, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain
| | | | | | - S Jesús
- Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - P Mir
- Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - M Aguilar
- Hospital Universitari Mutua de Terrassa, Terrassa, Barcelona, Spain
| | | | | | - N Caballol
- Consorci Sanitari Integral, Hospital Moisés Broggi, Sant Joan Despí, Barcelona, Spain
| | - I Legarda
- Hospital Universitario Son Espases, Palma de Mallorca, Spain
| | - I Cabo López
- Complejo Hospitalario Universitario de Pontevedra (CHOP), Pontevedra, Spain
| | | | - M A Ávila Rivera
- Consorci Sanitari Integral, Hospital General de L'Hospitalet, L'Hospitalet de Llobregat, Barcelona, Spain
| | - M J Catalán
- Hospital Universitario Clínico San Carlos, Madrid, Spain
| | - L M López Díaz
- Complejo Hospitalario Universitario de Ourense (CHUO), Ourense, Spain
| | - C Borrué
- Hospital Infanta Sofía, Madrid, Spain
| | | | - L Vela
- Fundación Hospital de Alcorcón, Madrid, Spain
| | - E Cubo
- Complejo Asistencial Universitario de Burgos, Burgos, Spain
| | | | | | - M G Alonso Losada
- Hospital Álvaro Cunqueiro, Complejo Hospitalario Universitario de Vigo (CHUVI), Vigo, Spain
| | | | - I Gastón
- Complejo Hospitalario de Navarra, Pamplona, Spain
| | - B Pascual-Sedano
- Hospital de Sant Pau, Barcelona, Spain; Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Spain; Faculty of Health Sciences, Universitat Oberta de Catalunya (UOC), Barcelona, Spain
| | - M Seijo
- Complejo Hospitalario Universitario de Pontevedra (CHOP), Pontevedra, Spain
| | | | - C Valero
- Hospital Arnau de Vilanova, Valencia, Spain
| | - M Kurtis
- Hospital Ruber Internacional, Madrid, Spain
| | | | | | - P Martinez-Martin
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Spain; CIBERNED, Instituto de Salud Carlos III, Madrid. COPPADIS Study Group, Spain
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Santos García D, Jesús S, Aguilar M, Planellas LL, García Caldentey J, Caballol N, Legarda I, Hernández Vara J, Cabo I, López Manzanares L, González Aramburu I, Ávila Rivera MA, Catalán MJ, López Díaz L, Puente V, García Moreno JM, Borrué C, Solano Vila B, Álvarez Sauco M, Vela L, Escalante S, Cubo E, Carrillo Padilla F, Martínez Castrillo JC, Sánchez Alonso P, Alonso Losada MG, López Ariztegui N, Gastón I, Kulisevsky J, Menéndez González M, Seijo M, Rúiz Martínez J, Valero C, Kurtis M, Fábregues‐Boixar O, González Ardura J, Prieto Jurczynska C, Martinez‐Martin P, Mir P, Adarmes Astrid D, Almeria M, Alonso Cánovas A, Alonso Frech F, Aneiros Díaz A, Arnáiz S, Arribas S, Ascunce Vidondo A, Bernardo Lambrich N, Bejr‐Kasem H, Blázquez Estrada M, Botí M, Cabello González C, Cámara Lorenzo A, Carrillo F, Casas E, Clavero P, Cortina Fernández A, Cots Foraster A, Crespo Cuevas A, de Deus Fonticoba T, Díez‐Fairen M, Erro E, Estelrich Peyret E, Fernández Guillán N, Gámez P, Gallego M, García Campos C, Gómez Garre MP, González Aloy J, González García B, González Palmás MJ, González Toledo GR, Golpe Díaz A, Grau Solá M, Guardia G, Horta‐Barba A, Infante J, Labandeira C, Labrador MA, Lacruz F, Lage Castro M, López Seoane B, Macías Y, Mata M, Martí Andres G, Martí MJ, McAfee D, Meitín MT, Méndez del Barrio C, Miranda Santiago J, Morales Casado MI, Moreno Diéguez A, Nogueira V, Novo Amado A, Novo Ponte S, Ordás C, Pagonabarraga J, Pareés I, Pascual‐Sedano B, Pastor P, Pérez Fuertes A, Pérez Noguera R, Prats MA, Pueyo Morlans M, Redondo Rafales N, Rodríguez Méndez L, Rodríguez Pérez AB, Roldán F, Ruíz De Arcos M, Sánchez‐Carpintero M, Sánchez Díez G, Sánchez Rodríguez A, Santacruz P, Segundo Rodríguez JC, Serarols A, Sierra Peña M, Suárez Castro E, Tartari JP, Vargas L, Vázquez Gómez R, Villanueva C, Vives B, Villar MD. COPPADIS
‐2015 (
CO
hort of Patients with PArkinson's
DI
sease in Spain, 2015): an ongoing global Parkinson's disease project about disease progression with more than 1000 subjects included. Results from the baseline evaluation. Eur J Neurol 2019; 26:1399-1407. [DOI: 10.1111/ene.14008] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 05/23/2019] [Indexed: 01/03/2023]
Affiliation(s)
- D. Santos García
- CHUAC, Complejo Hospitalario Universitario de A Coruña A CoruñaSpain
| | - S. Jesús
- Hospital Universitario Virgen del Rocío SevillaSpain
| | - M. Aguilar
- Hospital Universitari Mutua de Terrassa Terrassa Barcelona Spain
| | | | | | - N. Caballol
- Consorci Sanitari Integral Hospital Moisés Broggi Sant Joan Despí Barcelona Spain
| | - I. Legarda
- Hospital Universitario Son Espases Palma de MallorcaSpain
| | | | - I. Cabo
- Complejo Hospitalario Universitario de Pontevedra (CHOP) PontevedraSpain
| | | | | | - M. A. Ávila Rivera
- Consorci Sanitari Integral Hospital General de L'Hospitalet, L'Hospitalet de Llobregat Barcelona Spain
| | - M. J. Catalán
- Hospital Universitario Clínico San Carlos Madrid Spain
| | - L. López Díaz
- Complejo Hospitalario Universitario de Orense (CHUO) Orense Spain
| | | | | | | | - B. Solano Vila
- Institut d'Assistència Sanitària (IAS) – Institut Català de la Salut Girona Spain
| | | | - L. Vela
- Fundación Hospital de Alcorcón MadridSpain
| | - S. Escalante
- Hospital de Tortosa Verge de la Cinta (HTVC) Tortosa Tarragona Spain
| | - E. Cubo
- Complejo Asistencial Universitario de Burgos Burgos Spain
| | - F. Carrillo Padilla
- Hospital Universitario de Canarias San Cristóbal de la LagunaSanta Cruz de Tenerife Spain
| | | | | | - M. G. Alonso Losada
- Hospital Álvaro Cunqueiro Complejo Hospitalario Universitario de Vigo (CHUVI) Vigo Spain
| | | | - I. Gastón
- Complejo Hospitalario de Navarra Pamplona Spain
| | | | | | - M. Seijo
- Complejo Hospitalario Universitario de Pontevedra (CHOP) PontevedraSpain
| | | | - C. Valero
- Hospital Arnau de Vilanova Valencia Spain
| | - M. Kurtis
- Hospital Ruber Internacional Madrid Spain
| | | | | | | | - P. Martinez‐Martin
- Centro Nacional de Epidemiología y CIBERNED Instituto de Salud Carlos III Madrid Spain
| | - P. Mir
- Hospital Universitario Virgen del Rocío SevillaSpain
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Peña E, Mata M, López-Manzanares L, Kurtis M, Eimil M, Martínez-Castrillo JC, Navas I, Posada IJ, Prieto C, Ruíz-Huete C, Vela L, Venegas B. Antidepressants in Parkinson's disease. Recommendations by the movement disorder study group of the Neurological Association of Madrid. Neurologia 2016; 33:S0213-4853(16)00055-4. [PMID: 27004670 DOI: 10.1016/j.nrl.2016.02.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Revised: 01/29/2016] [Accepted: 02/01/2016] [Indexed: 01/07/2023] Open
Abstract
INTRODUCTION Although antidepressants are widely used in Parkinson's disease (PD), few well-designed studies to support their efficacy have been conducted. DEVELOPMENT These clinical guidelines are based on a review of the literature and the results of an AMN movement disorder study group survey. CONCLUSIONS Evidence suggests that nortriptyline, venlafaxine, paroxetine, and citalopram may be useful in treating depression in PD, although studies on paroxetine and citalopram yield conflicting results. In clinical practice, however, selective serotonin reuptake inhibitors are usually considered the treatment of choice. Duloxetine may be an alternative to venlafaxine, although the evidence for this is less, and venlafaxine plus mirtazapine may be useful in drug-resistant cases. Furthermore, citalopram may be indicated for the treatment of anxiety, atomoxetine for hypersomnia, trazodone and mirtazapine for insomnia and psychosis, and bupropion for apathy. In general, antidepressants are well tolerated in PD. However, clinicians should consider the anticholinergic effect of tricyclic antidepressants, the impact of serotonin-norepinephrine reuptake inhibitors on blood pressure, the extrapyramidal effects of antidepressants, and any potential interactions between monoamine oxidase B inhibitors and other antidepressants.
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Affiliation(s)
- E Peña
- Servicio de Neurología, Hospital Sanitas La Moraleja, Madrid, España.
| | - M Mata
- Servicio de Neurología, Hospital Infanta Sofía, Madrid, España
| | | | - M Kurtis
- Servicio de Neurología, Hospital Ruber Internacional, Madrid, España
| | - M Eimil
- Servicio de Neurología, Hospital de Torrejón, Madrid, España
| | | | - I Navas
- Servicio de Neurología, Hospital Fundación Jiménez Díaz, Madrid, España
| | - I J Posada
- Servicio de Neurología, Hospital 12 de Octubre, Madrid, España
| | - C Prieto
- Servicio de Neurología, Hospitales Rey Juan Carlos, Infanta Elena y Villalba, Madrid, España
| | - C Ruíz-Huete
- Servicio de Neurología, Clínica del Rosario, Madrid, España
| | - L Vela
- Servicio de Neurología, Hospital Fundación Alcorcón, Madrid, España
| | - B Venegas
- Servicio de Neurología, Hospitales Rey Juan Carlos, Infanta Elena y Villalba, Madrid, España
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