Circadian rhythm disorders and non-motor symptoms in different motor subtypes of Parkinson's disease

Abstract

The phenotype of the disease depends not only on the prevalence of certain motor signs, but also on non-motor symptoms. Determination of different profiles of Parkinson's disease improves disease prognosis and management. A clinical study was conducted in patients with Parkinson's disease. For this purpose, 64 patients with various motor subtypes of the disease were examined. Diagnosis was made according to the UK Brain Bank Criteria. The patients were divided into groups according to the motor subtype verified by the results of interference electroneuromyography. In each group, demographic data were collected, staging according to the Hoehn-Yahr scale and the overall score of the unified UPDRS scale were studied. The study of gait was evaluated using the Nonmotor Symptom Rating Scale for Parkinson's Disease (NMSS). The Munich Chronotype Questionnaire (MCTQ) was used to determine sleep onset, wake-up time, sleep duration, mid-sleep, average sleep duration, average weekly light exposure, chronotype, and for working patients, relative jet lag and average weekly sleep deficit. Circadian rhythm disorders were diagnosed according to the international classification of sleep disorders-3. Patients with Parkinson's disease have a more characteristic evening chronotype and a shorter sleep duration due to late sleep onset. On the other hand, the tendency towards the morning or evening chronotype is not associated with the severity of the disease or the level of daytime sleepiness. It was found that PD patients are characterized by more pronounced disorders of the gastrointestinal, genitourinary systems, sleep and cognitive-affective disorders, and others. In patients with a mixed motor subtype, mood and cognitive impairments are more pronounced, and gait disorders are more pronounced in patients with a mixed motor subtype. Thus, different motor subtypes of Parkinson's disease have differences in the severity of motor manifestations and features of the circadian rhythm. Circadian dysregulation is associated with features of daily functioning and disorders of the motor sphere.