Seasonal variations of nonmotor symptoms in patients with Parkinson's disease in Southeast China

Abstract. Background:. Studies suggest seasonal fluctuations of symptoms in Parkinson's disease (PD) patients in Western countries. However, the association between seasonal change and variation in nonmotor symptoms (NMS) in Chinese PD patients is unclear. Here, we studied whether there is a ch...

Full description

Bibliographic Details
Main Authors: Jingyi Wang, Kangping Xiong, Jingyuan Chao, Sheng Zhuang, Jie Li, Chunfeng Liu, Yanjie Yin
Format: Article
Language:English
Published: Wolters Kluwer 2023-02-01
Series:Chinese Medical Journal
Online Access:http://journals.lww.com/10.1097/CM9.0000000000002276
_version_ 1797840229676089344
author Jingyi Wang
Kangping Xiong
Jingyuan Chao
Sheng Zhuang
Jie Li
Chunfeng Liu
Yanjie Yin
author_facet Jingyi Wang
Kangping Xiong
Jingyuan Chao
Sheng Zhuang
Jie Li
Chunfeng Liu
Yanjie Yin
author_sort Jingyi Wang
collection DOAJ
description Abstract. Background:. Studies suggest seasonal fluctuations of symptoms in Parkinson's disease (PD) patients in Western countries. However, the association between seasonal change and variation in nonmotor symptoms (NMS) in Chinese PD patients is unclear. Here, we studied whether there is a change rule with annual cycle with severity of NMS for patients with PD in Southeast China. Methods:. We studied 1005 PD patients between April 2008 and October 2020. Patients were classified into four seasons according to the 24 Chinese solar terms, based on assessment date. We compared comprehensive NMS scales and polysomnography parameters among groups and conducted further analysis of disease severity. Results:. Among the 1005 patients studied, the mean age was 64.2 ± 9.7 years and 569 (56.6%) of them were men. Relative to the summer group, patients assessed during winter had higher Scales for Outcomes in Parkinson's disease-Autonomic Dysfunction (SCOPA-AUT) scores (P = 0.045). The sleep efficiency factor scores of Pittsburgh Sleep Quality Index in patients were higher during spring than summer (P = 0.009). Among patients who completed polysomnography during the same period (n = 135), compared with summer follow-ups, we observed a higher percentage of NREMS1 in winter and spring follow-ups (P = 0.042, P = 0.011), a higher NREMS1 time in spring follow-ups (P = 0.0024), a lower NREMS2 time in winter follow-ups (P = 0.007), and a higher percentage of phasic rapid eye movement (REM)-sleep without atonia in autumn and winter follow-ups (P = 0.026 and P = 0.020, respectively). In a subset of patients with PD and REM sleep behavior disorder (RBD; n = 182), those visited during winter had higher scores for RBD questionnaire-Hong Kong and its factor 1 (dream-related sub-score) than those visited during summer (P = 0.034, P = 0.020). We observed similar findings for SCOPA-AUT and sleep efficiency factor scores in early stage patients in subgroup analysis. Conclusions:. PD patients assessed for follow-up during summer showed less severe symptoms of autonomic dysfunction and RBD symptoms than those assessed in winter, and less sleep disturbance than those in spring and winter, suggesting that seasonal change and NMS fluctuation are related, especially in patients with early stage PD.
first_indexed 2024-04-09T16:11:31Z
format Article
id doaj.art-b25ce9e2baa841d5ab69bbab5fc4b420
institution Directory Open Access Journal
issn 0366-6999
2542-5641
language English
last_indexed 2024-04-09T16:11:31Z
publishDate 2023-02-01
publisher Wolters Kluwer
record_format Article
series Chinese Medical Journal
spelling doaj.art-b25ce9e2baa841d5ab69bbab5fc4b4202023-04-24T10:06:57ZengWolters KluwerChinese Medical Journal0366-69992542-56412023-02-01136441542210.1097/CM9.0000000000002276202302200-00005Seasonal variations of nonmotor symptoms in patients with Parkinson's disease in Southeast ChinaJingyi WangKangping XiongJingyuan ChaoSheng ZhuangJie LiChunfeng LiuYanjie YinAbstract. Background:. Studies suggest seasonal fluctuations of symptoms in Parkinson's disease (PD) patients in Western countries. However, the association between seasonal change and variation in nonmotor symptoms (NMS) in Chinese PD patients is unclear. Here, we studied whether there is a change rule with annual cycle with severity of NMS for patients with PD in Southeast China. Methods:. We studied 1005 PD patients between April 2008 and October 2020. Patients were classified into four seasons according to the 24 Chinese solar terms, based on assessment date. We compared comprehensive NMS scales and polysomnography parameters among groups and conducted further analysis of disease severity. Results:. Among the 1005 patients studied, the mean age was 64.2 ± 9.7 years and 569 (56.6%) of them were men. Relative to the summer group, patients assessed during winter had higher Scales for Outcomes in Parkinson's disease-Autonomic Dysfunction (SCOPA-AUT) scores (P = 0.045). The sleep efficiency factor scores of Pittsburgh Sleep Quality Index in patients were higher during spring than summer (P = 0.009). Among patients who completed polysomnography during the same period (n = 135), compared with summer follow-ups, we observed a higher percentage of NREMS1 in winter and spring follow-ups (P = 0.042, P = 0.011), a higher NREMS1 time in spring follow-ups (P = 0.0024), a lower NREMS2 time in winter follow-ups (P = 0.007), and a higher percentage of phasic rapid eye movement (REM)-sleep without atonia in autumn and winter follow-ups (P = 0.026 and P = 0.020, respectively). In a subset of patients with PD and REM sleep behavior disorder (RBD; n = 182), those visited during winter had higher scores for RBD questionnaire-Hong Kong and its factor 1 (dream-related sub-score) than those visited during summer (P = 0.034, P = 0.020). We observed similar findings for SCOPA-AUT and sleep efficiency factor scores in early stage patients in subgroup analysis. Conclusions:. PD patients assessed for follow-up during summer showed less severe symptoms of autonomic dysfunction and RBD symptoms than those assessed in winter, and less sleep disturbance than those in spring and winter, suggesting that seasonal change and NMS fluctuation are related, especially in patients with early stage PD.http://journals.lww.com/10.1097/CM9.0000000000002276
spellingShingle Jingyi Wang
Kangping Xiong
Jingyuan Chao
Sheng Zhuang
Jie Li
Chunfeng Liu
Yanjie Yin
Seasonal variations of nonmotor symptoms in patients with Parkinson's disease in Southeast China
Chinese Medical Journal
title Seasonal variations of nonmotor symptoms in patients with Parkinson's disease in Southeast China
title_full Seasonal variations of nonmotor symptoms in patients with Parkinson's disease in Southeast China
title_fullStr Seasonal variations of nonmotor symptoms in patients with Parkinson's disease in Southeast China
title_full_unstemmed Seasonal variations of nonmotor symptoms in patients with Parkinson's disease in Southeast China
title_short Seasonal variations of nonmotor symptoms in patients with Parkinson's disease in Southeast China
title_sort seasonal variations of nonmotor symptoms in patients with parkinson s disease in southeast china
url http://journals.lww.com/10.1097/CM9.0000000000002276
work_keys_str_mv AT jingyiwang seasonalvariationsofnonmotorsymptomsinpatientswithparkinsonsdiseaseinsoutheastchina
AT kangpingxiong seasonalvariationsofnonmotorsymptomsinpatientswithparkinsonsdiseaseinsoutheastchina
AT jingyuanchao seasonalvariationsofnonmotorsymptomsinpatientswithparkinsonsdiseaseinsoutheastchina
AT shengzhuang seasonalvariationsofnonmotorsymptomsinpatientswithparkinsonsdiseaseinsoutheastchina
AT jieli seasonalvariationsofnonmotorsymptomsinpatientswithparkinsonsdiseaseinsoutheastchina
AT chunfengliu seasonalvariationsofnonmotorsymptomsinpatientswithparkinsonsdiseaseinsoutheastchina
AT yanjieyin seasonalvariationsofnonmotorsymptomsinpatientswithparkinsonsdiseaseinsoutheastchina