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. 2021 Dec 17;11(12):2380.
doi: 10.3390/diagnostics11122380.

Diplopia Is Frequent and Associated with Motor and Non-Motor Severity in Parkinson's Disease: Results from the COPPADIS Cohort at 2-Year Follow-Up

Diego Santos García  1 , Lucía Naya Ríos  1 , Teresa de Deus Fonticoba  2 , Carlos Cores Bartolomé  1 , Lucía García Roca  1 , Maria Feal Painceiras  1 , Cristina Martínez Miró  1 , Hector Canfield  2 , Silvia Jesús  3   4 , Miquel Aguilar  5 , Pau Pastor  5 , Marina Cosgaya  6 , Juan García Caldentey  7 , Nuria Caballol  8 , Inés Legarda  9 , Jorge Hernández Vara  10 , Iria Cabo  11 , Lydia López Manzanares  12 , Isabel González Aramburu  4   13 , María A Ávila Rivera  14 , Víctor Gómez Mayordomo  15 , Víctor Nogueira  16 , Víctor Puente  17 , Julio Dotor  18 , Carmen Borrué  19 , Berta Solano Vila  20 , María Álvarez Sauco  21 , Lydia Vela  22 , Sonia Escalante  23 , Esther Cubo  24 , Francisco Carrillo Padilla  25 , Juan C Martínez Castrillo  26 , Pilar Sánchez Alonso  27 , Maria G Alonso Losada  28 , Nuria López Ariztegui  29 , Itziar Gastón  30 , Jaime Kulisevsky  4   31 , Marta Blázquez Estrada  32 , Manuel Seijo  11 , Javier Rúiz Martínez  33 , Caridad Valero  34 , Mónica Kurtis  35 , Oriol de Fábregues  10 , Jessica González Ardura  36 , Ruben Alonso Redondo  37 , Carlos Ordás  38 , Luis M López Díaz  39 , Darrian McAfee  40 , Pablo Martinez-Martin  4 , Pablo Mir  3   4
Affiliations

Diplopia Is Frequent and Associated with Motor and Non-Motor Severity in Parkinson's Disease: Results from the COPPADIS Cohort at 2-Year Follow-Up

Diego Santos García et al. Diagnostics (Basel). .

Abstract

Background and objective: Diplopia is relatively common in Parkinson's disease (PD) but is still understudied. Our aim was to analyze the frequency of diplopia in PD patients from a multicenter Spanish cohort, to compare the frequency with a control group, and to identify factors associated with it.

Patients and methods: PD patients who were recruited from January 2016 to November 2017 (baseline visit; V0) and evaluated again at a 2-year ± 30 days follow-up (V2) from 35 centers of Spain from the COPPADIS cohort were included in this longitudinal prospective study. The patients and controls were classified as "with diplopia" or "without diplopia" according to item 15 of the Non-Motor Symptoms Scale (NMSS) at V0, V1 (1-year ± 15 days), and V2 for the patients and at V0 and V2 for the controls.

Results: The frequency of diplopia in the PD patients was 13.6% (94/691) at V0 (1.9% in controls [4/206]; p < 0.0001), 14.2% (86/604) at V1, and 17.1% (86/502) at V2 (0.8% in controls [1/124]; p < 0.0001), with a period prevalence of 24.9% (120/481). Visual hallucinations at any visit from V0 to V2 (OR = 2.264; 95%CI, 1.269-4.039; p = 0.006), a higher score on the NMSS at V0 (OR = 1.009; 95%CI, 1.012-1.024; p = 0.015), and a greater increase from V0 to V2 on the Unified Parkinson's Disease Rating Scale-III (OR = 1.039; 95%CI, 1.023-1.083; p < 0.0001) and Neuropsychiatric Inventory (OR = 1.028; 95%CI, 1.001-1.057; p = 0.049) scores were independent factors associated with diplopia (R2 = 0.25; Hosmer and Lemeshow test, p = 0.716).

Conclusions: Diplopia represents a frequent symptom in PD patients and is associated with motor and non-motor severity.

Keywords: PIGD; Parkinson’s disease; Tremor; changes; motor; phenotype.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
(A) Percentage of patients and controls reporting diplopia at different visits: V0, V1, V2. (B) Prevalence of diplopia during the follow-up period in all patients who completed the three visits (N = 481; V1, V2, V3) and percentage of cases presenting diplopia in only 1 visit, 2 visits, and all visits.
Figure 2
Figure 2
(A) Number of patients reporting visual hallucinations at V0, V1, and V2 when they were divided in patients with vs. without diplopia. (B) Percentage of patients reporting visual hallucinations at least once during the follow-up according to the times who reported diplopia.
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