Factors associated with asymmetric symptoms of Parkinson’s disease in South Africa

Abstract

Introduction: Parkinson’s Disease (PD) is a neurodegenerative disorder resulting from the death of dopamine-producing neurons in the substantia nigra pars compacta and from the development of Lewy bodies in the neuronal cell body. The motor symptoms of PD usually develop asymmetrically and is often predated by non-motor symptoms.

Aims and objectives: This study identified the potential predictive factors (demographics, handedness and non-motor symptoms) that are associated with asymmetric symptoms in South African PD patients.

Methods: Diagnosed PD patients were recruited from Sandton Mediclinic and Wits Donald Gordon Medical Centre in Johannesburg, South Africa. Relevant inclusion and exclusion criteria were applied to obtain an appropriate sample (n=59). A questionnaire was created on REDCap and distributed via email. The data was captured and analysed on Microsoft Excel and STATA.

Results: Asymmetry changes over time and with severity of disease as there were associations between current laterality and age (p=0.003), between stage of PD and initial laterality (p=0.023), and between current laterality (p<0.0001) and change in symptom asymmetry (p<0.0001). Asymmetry is related to non-motor symptoms of PD as daytime sleepiness was associated with current asymmetry (p=0.010) and change in symptom asymmetry (p=0.005). Current asymmetry was associated with pain (p = 0.042) and constipation was associated with current asymmetry (p=0.016) and change in symptom asymmetry (p=0.008). Depression was associated with change in symptom asymmetry (p=0.034).

Conclusion: The importance of symptom asymmetry in PD patients is undeniable, therefore, further research is needed as it could be the key to the future management and treatment of this neurodegenerative disorder.