Clinical features in Parkinson's disease: characterization of urinary symptoms according to Parkinson disease subtype

Abstract

Purpose:

To evaluate whether lower urinary tract symptoms (LUTS) differ among clinical subtypes of PD and the association between urinary disorders and motor and non-motor features, quality of life (QoL), and disease variables.

Methods:

Subjects underwent to the unified Parkinson's disease rating scale (UPDRS) motor section part III, Hoehn-Yahr (H&Y) scale and mini-mental state examination (MMSE) to evaluate motor symptoms, the stage of disease severity, and cognitive function, respectively. Patients were divided into tremor-dominant type (TDT), akinetic-rigid type (ART), and mixed type (MXT) PD subgroups. Urinary symptoms were evaluated with 3-day voiding diary, uroflowmetry, and the incontinence quality of life questionnaires (I-QoL); psychological status by Hamilton anxiety scale (HAM-A) and Hamilton depression scale (HAM-D).

Results:

52 patients were enrolled; mean (± SD) age: 66.5 ± 9.6 yrs. All patients complained about at least one LUTS: 92% had urgency, 83% had increased urinary frequency, and 77% had nocturia. Disease duration was positively related to an increase in urinary frequency (p = 0.06), nocturia (p = 0.03), and negatively related to Qmax (p = 0.01). The rate of urinary frequency increased with the increase of HAM-D score (p < 0.001). The number of nocturia episodes was expression of more severe disease, as expressed by UPDRS (p < 0.001) and worse scores in HAM-A (p = 0.01) and HAM-D scores (p = 0.04). A correlation was observed between urinary frequency and HAM-A scores (p = 0.01). No significant different was observed between the clinical subtypes.

Conclusion:

Our results suggest that LUTS correlate with the severity of motor and non- motor impairment, demonstrating also that LUTS occurrence was irrespective to PD clinical features.