Premotor Symptoms as Predictors of Outcome in Parkinsons Disease: A CaseControl Study Yu-Hsuan Wu1, Wei-Ju Lee1,2, Yi-Huei Chen3, Ming-Hong Chang1,2☯*, Ching-Heng Lin3☯* 1 Section of Neurology, Taichung Veterans General Hospital, Taichung, Taiwan, 2 Department of Neurology, National Yang-Ming University School of Medicine, Taipei, Taiwan, 3 Department of Medical education and Research, Taichung Veterans General Hospital, Taichung, Taiwan ☯ These authors contributed equally to this work. * [email protected]
(M-HC); [email protected]
Abstract Background OPEN ACCESS Citation: Wu Y-H, Lee W-J, Chen Y-H, Chang M-H, Lin C-H (2016) Premotor Symptoms as Predictors of Outcome in Parkinsons Disease: A Case-Control Study. PLoS ONE 11(8): e0161271. doi:10.1371/ journal.pone.0161271 Editor: Mathias Toft, Oslo Universitetssykehus, NORWAY Received: June 20, 2016 Accepted: August 2, 2016 Published: August 17, 2016 Copyright: © 2016 Wu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability Statement: All relevant data are within the paper and its Supporting Information files. Funding: Full financial support for all authors came from the Taichung Veterans General Hospital (TCVGH-1053402C and TCVGH-1053404D). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Competing Interests: The authors have declared that no competing interests exist.
To evaluate the association between the premotor symptoms and the prognosis of PD.
Methods A total of 1213 patients who were diagnosed of PD from January 2001 to December 2008 were selected from the Taiwan’s National Health Insurance Research Database. Patients were traced back to determine the presence of premotor symptoms, including rapid eye movement sleep behavior disorder (RBD), depression, and constipation. Cox’s regression analysis was used to detect the risks between the occurrence of premotor symptoms and the outcome (including death, psychosis, accidental injury, dementia and aspiration pneumonia). In addition, the association between premotor symptoms and levodopa equivalent dosage (LED) was examined.
Results Higher occurrence of death, dementia and aspiration pneumonia were identified in PD patients with premotor symptoms than without premotor symptoms (HR 169, 95% CI 134– 214, p