Title: Socio-demographic and clinical profile of Parkinsonism patients attending a tertiary care hospital of north India
Authors: Dr Shubana Ashraf, Dr Atif Rasool Kawoosa, Dr Sheikh Mohamad Tahir
DOI: https://dx.doi.org/10.18535/jmscr/v7i4.55
Abstract
Background: Parkinsonism is a clinical syndrome of akinesia, with or without rigidity, tremor, and postural and gait disturbance. It may be caused by primary degenerative conditions of the brain involving the basal ganglia. We conducted this study with the aim to study the demographic and clinical features of patients with degenerative Parkinsonism presenting to Indraprastha Apollo Hospitals.
Methods: A prospective observational study was conducted at Indraprastha Apollo Hospital between September 2014 and June 2016.A total of 80 patients were enrolled for the study after taking an informed written consent. Among the 80 patients, 40 patients were typical Parkinson’s disease patients and the other 40 were atypical Parkinsonism patients.
Results: In this study we recruited a total of 80 patients which included 40 patients of parkinsonism and 40 patients of atypical parkinsonism. Among the parkinsonism patients, 27 (67.5%) were males, 3 (7.5%) had family history of parkinsonism and 28(70%) were on levodopa-carbidopa therapy. The mean age among typical parkinsonism patients was 66.25±10.55 (mean±SD), mean age of disease onset was 60.64±11.76 and mean duration of the disease was 5.65±4.54. The mean Hoehn and Yahr was 2.54.The mean UPDRS (stage 1-3) was 45.98±21.98 and the mean UPDRS (stage 3) was 31.53±17.39. According to UPDRS part 1- item 4, the mean apathy score was 0.11±0.21), the mean HAMD score in typical Parkinsonism was 6.13±7.66, and mean MMSE score in was 27.75±4.64.
Conclusion: Our study demonstrated socio-demographic and clinical presentation of Parkinsonism patients in our setup. Most common comorbid conditions were also identifies.
Keywords: Parkinsonism, atypical parkinsonism, neurological diseases.
References
- DeMaagd G, Philip A. Parkinson's Disease and Its Management: Part 1: Disease Entity, Risk Factors, Pathophysiology, Clinical Presentation, and Diagnosis. P T. 2015;40(8):504–532.
- Williams DR, Litvan I. Parkinsonian syndromes. Continuum (MinneapMinn). 2013;19(5 Movement Disorders):1189–1212. doi:10.1212/01.CON.000043
- Wenning GK, Krismer F, Poewe W. New insights into atypical parkinsonism. Curr Opin Neurol. 2011;24(4):331–338. doi:10.1097/WCO.0b013e3283480569 6152.24038.e0
- Aarsland D, Taylor JP, Weintraub D. Psychiatric issues in cognitive impairment. Mov Disord. 2014;29(5):651–662. doi:10.1002/mds.25873
- Mostafa AA, Poletti M. Neural and behavioral substrates of subtypes of Parkinson’s disease. Frontiers in Systems Neuroscience. 2013;7:1-11.
- Fahn S, Elton RL. Members of the UPDRS Development Committee. Unified Parkinson’s Disease Rating Scale. In: Fahn S, Marsden CD, Calne DB, et al., editors. Recent Developments in Parkinson’s Disease. 2. Florham Park, New Jersey: McMillan Health Care Information; 1987 PP 153-163
- Lewis SJ, Foltynie T, Blackwell AD, Robbins TW, Owen AM, Barker RA. Heterogeneity of Parkinson’s disease in the early clinical stages using a data driven approach.J Neurol Neurosurg Psychiatry. 2005;76(3):343–348. doi: 10.1136/jnnp.2003.033530.
- Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician.J Psychiatr Res. 1975;12 (3):189–198. doi: 10.1016/0022-3956(75)90026-6.
- The Hamilton rating scale for depression, journal of operational psychiatry, 1979;10(2): 149-165.
- Lewis SJ, Foltynie T, Blackwell AD, Robbins TW, Owen AM, Barker RA. Heterogeneity of Parkinson’s disease in the early clinical stages using a data driven approach.J Neurol Neurosurg Psychiatry 2005;76(3):343–348. doi: 10.1136/jnnp.2003.033530.
- Pinglui , Tao Feng, Bio chen et al; Clinical heterogeneity in patients with early stage Parkinson’s disease: a cluster analysis.;J Zhejiang Uni Sci B Sep 2011; v. 12(9) 694-703
- Chaudhuri, K.R., Naidu, Y., 2008. Early Parkinson’s disease and non-motor issues. J. Neurol., 255(s5):33-38. [doi: 10.1007/s00415-008-5006-1]
- Gozdek, L., Laskowska, I., Michalak, M., & Gorzelańczyk, E. (2007). Ocenajakościżyciaosób z chorobą Parkinsona .Polskie Forum Psychologiczne 12(1), 51–62.
- Yamanishi, T., Tachibana, H., Oguru, M., Matsui, K., Toda, K.,Okuda, B., & Oka, N. (2013). Anxiety and depression in patients with Parkinson’s disease. Internal Medicine 52(5), 539–545.
- Žiropađa, L., Stefanova, E., Potrebić, A.,& Kostić,V.S.(2009). Quality of life in Serbian patients with Parkinson’s disease. Quality of Life Research,18(7), 833–839.