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Title:	Nonmotor Symptoms In Lrrk2 G2019s Associated Parkinson's Disease
Author:	Gaig Ventura, Carles; Vilas Rolán, Dolores; Infante, Jon; Sierra, María; García Gorostiaga, Inés; Buongiorno, Maria Teresa; Ezquerra, Mario; Martí Domènech, Ma. Josep; Valldeoriola Serra, Francesc; Aguilar, Miquel; Calopa, Matilde; Hernández Vara, Jorge; Tolosa, Eduardo
Notes:	Background: Idiopathic Parkinson's disease (IPD) and LRRK2-associated PD (LRRK2-PD) might be expected to differ clinically since the neuropathological substrate of LRRK2-PD is heterogeneous. The range and severity of extra-nigral nonmotor features associated with LRRK2 mutations is also not well-defined. Objective: To evaluate the prevalence and time of onset of nonmotor symptoms (NMS) in LRRK2-PD patients. Methods: The presence of hyposmia and of neuropsychiatric, dysautonomic and sleep disturbances was assessed in 33 LRRK2-G2019S-PD patients by standardized questionnaires and validated scales. Thirty-three IPD patients, matched for age, gender, duration of parkinsonism and disease severity and 33 healthy subjects were also evaluated. Results: University of Pennsylvania Smell Identification Test (UPSIT) scores in LRRK2-G2019S-PD were higher than those in IPD (23.5 +/- 6.8 vs 18.4 +/- 6.0; p = 0.002), and hyposmia was less frequent in G2019S carriers than in IPD (39.4% vs 75.8%; p = 0.01). UPSIT scores were significantly higher in females than in males in LRRK2-PD patients (26.9 +/- 4.7 vs 19.4 +/- 6.8; p < 0.01). The frequency of sleep and neuropsychiatric disturbances and of dysautonomic symptoms in LRRK2-G2019S-PD was not significantly different from that in IPD. Hyposmia, depression, constipation and excessive daytime sleepiness, were reported to occur before the onset of classical motor symptoms in more than 40% of LRRK2-PD patients in whom these symptoms were present at the time of examination. Conclusion: Neuropsychiatric, dysautonomic and sleep disturbances occur as frequently in patients with LRRK2-G2019S-PD as in IPD but smell loss was less frequent in LRRK2-PD. Like in IPD, disturbances such as hyposmia, depression, constipation and excessive daytime sleepiness may antedate the onset of classical motor symptoms in LRRK2-G2019S-PD.
Subject(s):	-Malaltia de Parkinson -Trastorns del son -Parkinson's disease -Sleep disorders
Rights:	cc by (c) Gaig Ventura et al., 2014 http://creativecommons.org/licenses/by/3.0/es/
Document type:	Article Article - Published version
Published by:	Public Library of Science (PLoS)
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