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[Subjective blockage in Parkinson's disease].
L Volpe-Gillot1, A Créange, J D Degos
1Département de Neurosciences, Hôpital Henri Mondor, Créteil, France.
Revue Neurologique
|April 20, 2002
Summary
Subjective non-motor symptoms are common in Parkinson's disease off-periods, often underestimated. These symptoms can significantly impact daily life, even without motor akinesia.
Area of Science:
- Neurology
- Neuroscience
- Movement Disorders
Background:
- Parkinson's disease (PD) is characterized by motor symptoms, but non-motor symptoms also significantly affect patients.
- Motor fluctuations and 'off-periods' in PD can be accompanied by various subjective experiences.
Observation:
- A systematic interview of 24 Parkinson's disease patients revealed that 67% experienced subjective non-motor symptoms during off-periods.
- These symptoms were categorized into asthenia, perceptive/cognitive alterations, and emotional disturbances (panic, depression).
- Notably, in some cases, these subjective symptoms occurred independently of motor akinesia and could severely inhibit daily activities.
Findings:
- Subjective off-periods are frequent in Parkinson's disease, with an underestimation likely due to non-targeted patient examinations.
- These subjective phenomena are partly independent of motor symptoms and can persist even after therapeutic interventions like subthalamic nucleus stimulation or transplantation.
- Patients often do not differentiate these subjective off-periods from their motor disability.
Implications:
- Recognizing and evaluating subjective off-periods is crucial for a comprehensive assessment of Parkinson's disease.
- The persistence of these symptoms can interfere with functional outcomes following surgical treatments.
- Future therapeutic evaluations, particularly for surgical interventions, must consider subjective off-periods as significant outcomes.