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. 2015 Jan 8;4(1):1.
doi: 10.1186/2047-9158-4-1. eCollection 2015.

Meta-analyses on prevalence of selected Parkinson's nonmotor symptoms before and after diagnosis

Honglei Chen  1 , Edward J Zhao  1 , Wen Zhang  1 , Yi Lu  2 , Rui Liu  1 , Xuemei Huang  3 , Anna J Ciesielski-Jones  2 , Michele A Justice  2 , Deborah S Cousins  2 , Shyamal Peddada  4
Affiliations

Meta-analyses on prevalence of selected Parkinson's nonmotor symptoms before and after diagnosis

Honglei Chen et al. Transl Neurodegener. .

Abstract

Background: Nonmotor symptoms are common among patients with Parkinson's disease (PD) and some may precede disease diagnosis.

Methods: We conducted a meta-analysis on the prevalence of selected nonmotor symptoms before and after PD diagnosis, using random-effect models. We searched PubMed (1965 through October/November 2012) for the following symptoms: hyposmia, constipation, rapid eye movement sleep behavior disorder, excessive daytime sleepiness, depression, and anxiety. Eligible studies were publications in English with original data on one or more of these symptoms.

Results: The search generated 2,373 non-duplicated publications and 332 met the inclusion criteria, mostly (n = 320) on symptoms after PD diagnosis. For all symptoms, the prevalence was substantially higher in PD cases than in controls, each affecting over a third of the patients. Hyposmia was the most prevalent (75.5% in cases vs. 19.1% in controls), followed by constipation (50% vs. 17.7%), anxiety (39.9% vs. 19.1%), rapid eye movement sleep behavior disorder (37.0% vs. 7.0%), depression (36.6% vs. 14.9%), and excessive daytime sleepiness (33.9% vs. 10.5%). We observed substantial heterogeneities across studies and meta-regression analyses suggested that several factors might have contributed to this. However, the prevalence estimates were fairly robust in several sensitivity analyses. Only 20 studies had data on any symptoms prior to PD diagnosis, but still the analyses revealed higher prevalence in future PD cases than in controls.

Conclusion: These symptoms are common among PD patients both before and after diagnosis. Further studies are needed to understand the natural history of nonmotor symptoms in PD and their etiological and clinical implications.

Keywords: Meta-analysis; Natural history; Nonmotor symptoms; Parkinson’s disease; Prevalence.

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Figures

Figure 1
Figure 1
Flow chart of literature review and data abstraction.
Figure 2
Figure 2
Meta-analysis of the prevalence of selected non-motor symptoms after PD diagnosis.
Figure 3
Figure 3
Meta-analysis of the prevalence of selected non-motor symptoms prior to PD diagnosis.
See this image and copyright information in PMC

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