- Email: [email protected]
Validation of the Italian non motor symptoms questionnaire and non motor symptoms scale for Parkinson's disease
e38
Abstracts / Parkinsonism and Related Disorders 22 (2016) e29ee75
Results: PDQ-39 had significantly correlated with GSRS items of diarrhea and constipation, PFS-16, BDI-II and PDSS. It is revealed that PFS-16, GSRS item of constipation and PDSS correlated with PDQ-39 by logistic regression analysis. PFS-16 had most significant correlation with PDQ-39 among those factors (p < 0.01). Conclusions: Bowel movement disorder, fatigue, depression, and sleep disturbance were correlated with QOL in de novo PD. Fatigue was, specifically, highly correlated with QOL in these factors. We should be aware of possibility of improvement of QOL by focusing on these symptoms. P 1.038. ASSESSING THE NON-MOTOR SYMPTOM BURDEN PROGRESSION IN A LONGITUDINAL STUDY OF 411 PARKINSON'S PATIENTS, USING THE NON-MOTOR SYMPTOM QUESTIONNAIRE Miguel Grilo 1, Dhaval Trivedi 1, Elisa Moti 1, Rui Barreto 1, Anna Sauerbier 2, Alexandra Rizos 1, Lauren Perkins 1, Rona Inniss 1, Theresa Chiwera 1, K. Ray Chaudhuri 2. 1 National Parkinson Foundation International Centre of Excellence, Department of Neurology, King's College Hospital, London, United Kingdom; 2 National Parkinson Foundation International Centre of Excellence, Department of Neurology, King's College Hospital, Maurice Wohl Clinical Neuroscience Centre, King's College, London, United Kingdom Objectives: Our aim was to evaluate in a holistic manner the progression of non-motor symptoms (NMS) burden in Parkinson's disease (PD) using validated NMS Questionnaire (NMSQuest) cut off scores (Chaudhuri K R et al, 2015). Methods: We reviewed the data of PD patients from a European longitudinal study and compared the NMS burden score at baseline, 12 and 24 months follow-up. Demographics and Hoehn and Yahr classification (HY) were collated for 411 patients. Results: Out of 411 patients (mean age 45.1±10.8 years, duration of disease 5.1±4.8 years, median HY¼2, 58.6% male), 60 were reassessed at 12 months and 40 at 24 months (figure 1). HY and NMSQuest burden scores showed a moderate correlation at baseline (rs(n¼411)¼0.389, p<0.0005). Comparison of NMSQuest burden score at baseline and at 12 and 24 months did not show significant median differences (z¼-1.278, p<0.061 and z¼-1.455, p<0.122, respectively). Patients with HY2 did not show significant differences between NMSQuest burden scores at follow up as well as those with HY>2 (HY2:z¼-0.555, p<0.184 and z¼-0.894; p<0.157; HY>2 z¼-0.970, p<0.185 and z ¼ -0.866, p<0.356, respectively). Conclusions: The preliminary results of this study are in line with studies reporting that patients might have a heterogeneous NMS burden despite disease evolution and motor staging. This emphasizes the importance of a regular assessment and revaluation of NMS.
Objectives: Parkinson's disease (PD) is a chronic and progressive neurological condition in which non-motor disturbances as well as motor deficits significantly impact quality of life. The objective of the study is aimed at exploring the quality of life of patients with PD, depending on gender, age, form of the disease and the severity of cognitive impairment. Methods: The study was conducted at Neurology Department, Tashkent Medical Academy. All patients with Parkinson's disease seen in a population based study on the prevalence of parkinsonism were asked to complete a disease-specific QoL questionnaire (PDQ-39). A structured questionnaire interview and a complete neurological examination, including the Hoehn and Yahr scale, the Schwab and England disability scale, the motor part of the unified Parkinson's disease rating scale (UPDRS part III), and the MMSE were performed by a neurologist. Results: The results have shown that between 2013-2014 here were 82 cases of PD, 55,6% of which were among female, 44,4-male,age categories: from 45 to 72 years. No significant differences were found in terms of the age and the sex of patients. Significant differences were found in the form of the disease, standard of living with a tremor form was lover than an akinetic and a mixed. The assessment of QoL depending on severity of cognitive impairment showed that patients with mild dementia have lower standard of living. Conclusion: Parkinson's disease restrict the quality of life in areas such as mobility, daily activities, disease symptoms, emotional and cognitive functions most of the patients feel lower quality of life. P 1.040. VALIDATION OF THE ITALIAN NON MOTOR SYMPTOMS QUESTIONNAIRE AND NON MOTOR SYMPTOMS SCALE FOR PARKINSON'S DISEASE Ilaria Cova 1, Nicola Vanacore 2, Patrizia Contri 1, Giuseppe Meco 3, Simone Pomati 1, Giulia Grande 1, Eleonora Lacorte 2, Alberto Priori 4, Claudio Mariani 1. 1 Department of Neurology, Luigi Sacco Hospital, University of Milan, Milan, Italy; 2 National Institute of Health, Rome, Italy; 3 Department of Neurological Sciences, Sapienza University, Rome, Italy; 4 Department of Neurology, San Paolo Hospital, University of Milan, Milan, Italy Objectives: To validate Italian version of Non Motor Symptoms Questionnaire (NMSQuest) and Non Motor Symptoms Scale (NMSS), tools for quantify and qualify non-motor symptoms in Parkinson's disease (PD). Methods: Ninety Italian PD1 outpatients will be asked to complete the Italian NMSQuest and NMSS. Mini-Mental Parkinson will be used to investigate cognitive disorders, Hamilton Rating Scale for depression and MDS-UPDRS for motor and non-motor assessment. NMSQuest and NMSS will be repeated in a subset of 20 PD patients after 1month to assess the reliability of non-motor symptoms. A correlation analysis between the scores of all scales and questionnaires used will be performed. The intraclass correlation index will be adopted to assess the reliability. A p value of 5% will be considered as statistically significant. Results: In a preliminary analysis on 21 PD patients (mean age 67.2±8.3
Hoehn and Yahr & NMSQuest Levels at Baseline (n¼411). NMSQuest Levels
HY
Total Number Total %
1.0 1.5 2.0 2.5 3.0 4.0 5.0
None
Mild
Moderate
Severe
Very Severe
2 1 2 2 2 0 0 9 2.2%
34 2 25 4 13 2 2 82 20.0%
24 3 31 6 40 8 3 115 28.0%
14 2 32 4 41 11 3 107 26.0%
6 0 16 6 39 23 8 98 23.8%
P 1.039. QUALITY OF LIFE IN PATIENTS WITH PARKINSON'S DISEASE IN UZBEKISTAN Mukhlisa Khanova 2, Oybek Navruza Tolibova 1, Turgunkhujaev 1. 1 Department of Neurology, Tashent Medical Academy, Tashkent, Uzbekistan; 2 Department of Neurology, Tashkent Pediatric Medical Institute, Tashkent, Uzbekistan
Total Number
Total %
80 8 106 22 135 44 16 411 100.0%
19.5% 1.9% 25.8% 5.4% 32.8% 10.7% 3.9% 100.0%
years; 33% females, disease duration 6.4±4.6 years),no statistical differences were found in comparison between patients with H&Y2 (n¼15) and H&Y3 (n¼6) in the total score of NMSQuest (9.1±6.3 vs. 10.5±4.4; p ¼ 0.61) and NMSS (41.9±53.3 vs. 38.0±20.8; p ¼ 0.86). Conclusions: In the preliminary analysis the Italian version of NMSQuest and of NMSS exhibited good reliability and validity for the assessment of non motor symptoms in Italian PD patients. This first analysis further outlines the importance of record non motor symptoms of PD even in early
Abstracts / Parkinsonism and Related Disorders 22 (2016) e29ee75
motor stage, in order to identify and manage non-motor symptoms in PD. References: 1. Gelb DJ, Oliver E, Gilman S. Diagnostic criteria for Parkinson's disease. Arch Neurol 1999;56:33-39. P 1.041. PARKINSON DISEASE NON-MOTOR PROFILE AND MAPT HAPLOTYPES Maria Elena Di Battista 1, Alfonso Rubino 1, Chiara Papi 1, Marcella Valente 2, Esterina Pascale 3, Carlo Purcaro 1, Giuseppe Meco 1. 1 Department of Neurology and Psychiatry (Parkinson's Centre), Sapienza University, Rome, Italy; 2 Research Centre of Social Diseases (CIMS), Sapienza University, Rome, Italy; 3 Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University, Rome, Italy Objectives: Given the convergent data indicating a role of MAPT in Parkinson's disease, we sought to explore the effect of MAPT background (H1/ H1 homozygous vs H2 carriers) in the whole spectrum of non-motor symptoms in a cohort of patients with idiopathic PD. Methods: One hundred and eleven PD patients without dementia were enrolled. Patients were assessed with the following scales: BDI for depressive symptoms; Montreal Cognitive Assessment (MOCA) for the evaluation of cognitive status and to exclude patients with severe cognitive dysfunctions; SCOPA-AUT to assess the wide spectrum of dysautonomic dysfunctions; Non Motor Symptoms Scale (NMSS) concerning frequency and severity of a wide range of NMS; Epworth Sleepiness Scale (EPSS) for sleep disturbance evaluation; Neuropsychiatric Inventory Scale (NPI) to assess the presence of psychotic symptoms. Results: H1 homozygous and H2 carriers were comparable with regard to age, age at onset and disease duration. No difference emerged in cognitive global efficacy (MOCA) or specific cognitive domain. Neuropsychiatric complaints and mood disorders were differently distributed across the two groups, as well as sleep disturbances. No difference was observed in the overall burden of non-motor symptoms assessed with SCOPA-AUT and NMSS. However, cardiovascular and thermoregulation dysfunctions were significantly associated with H1/H1 backgrounds in the subgroup of patients with akinetic-rigid motor phenotype. Conclusions: MAPT background did not impact the frequency and severity of non-motor symptoms in our cohort of PD patients without dementia. Cardiovascular and thermoregulation dysfunctions were significantly associated with H1 homozygosity only in the akinetic-rigid subgroup. P 1.042. SLEEP AND MOOD PREDICT QUALITY OF LIFE CHANGE IN PARKINSON'S DISEASE: A LONGITUDINAL STUDY Kumar M. Prakash 1, Nivedita Nadkarni 2, Weng-Kit Lye 2, Ming-Hui Yong 3, Eng-King Tan 1. 1 Department of Neurology, Singapore General Hospital, National Neuroscience Institute, Duke-NUS Graduate Medical School, Singapore, Singapore; 2 Centre for Quantitative Medicine, Duke-NUS Graduate Medical School, Singapore, Singapore; 3 Department of Neurology, Singapore General Hospital, Singapore, Singapore Objectives: Non-motor symptoms (NMS) are common among patients with Parkinson's disease (PD) however little is known about the influence of its burden on the health-related quality of life (QoL) over a defined follow-up period. Our study was aimed to establish the impact of NMS burden change on the change in QoL of patients with PD over a 2-year follow-up period. Methods: Newly referred PD patients were prospectively enrolled and followed-up for up to 24 months. Non-motor symptoms scale (NMSS) was used to evaluate the burden of NMS while QoL was assessed with the Parkinson's disease Questionnaire-39 items (PDQ-39). Motor disabilities were assessed using the Part III (motor) Unified Parkinson's Disease Rating Scale (UPDRSm). Results: The multivariate analysis showed that total NMS burden change significantly predicted the change in the QoL scores while motor scores did not. Among the various domains of NMS, domains 2 (sleep/ fatigue) and 3 (mood/ apathy) were most significantly predictive of QoL change. Conclusions: NMS burden changes, in particular sleep and mood, have significantly greater impact on the change in quality of life of Parkinson's disease patients over a 2-year follow-up period.
e39
References: 1. Barone P, Antonini A, Colosimo C, Marconi R, Morgante L, Avarello TP, et al., The PRIAMO study: A multicenter assessment of nonmotor symptoms and their impact on quality of life in Parkinson's disease. Mov Disord 2009;24:1641-1649. 2. Song W, Guo X, Chen K, Chen X, Cao B, Wei Q, Huang R, Zhao B, Wu Y, Shang HF. The impact of non-motor symptoms on the Health-Related Quality of Life of Parkinson's disease patients from Southwest China. Parkinsonism Relat Disord. 2014;20:149-152. ndez R. Impact of non-motor 3. Santos-García D, de la Fuente-Ferna symptoms on health-related and perceived quality of life in Parkinson's disease. J Neurol Sci. 2013;332;136-140. 4. Shearer J, Green C, Counsell CE, Zajicek JP. The impact of motor and non motor symptoms on health state values in newly diagnosed idiopathic Parkinson's disease. J Neurol. 2012;259:462-468. 5. Martinez-Martin P, Rodriguez-Blazquez C, Kurtis MM, Chaudhuri KR; NMSS Validation Group. The impact of non-motor symptoms on healthrelated quality of life of patients with Parkinson's disease. Mov Disord. 2011;26:399-406. P 1.043. FREQUENCY AND SLEEP STAGE SEQUENCE OF SOREM PERIODS IN PARKINSON'S DISEASE Tobias Murer 1, Esther Werth 2, Rositsa Poryazova 3, Yury Gavrilov 3, Daniel Waldvogel 3, Christian Baumann 3, Philipp Valko 3. 1 Department of Neurology, University Hospital Zurich, Zurich, Switzerland; 2 Department of Neurology, University Hospital Zurich, University Hospital Zurich, Switzerland; 3 Department of Neurology, University Hospital Zurich, Department of Neurology, University Hospital Zurich, Switzerland Objectives: The presence of multiple sleep onset REM sleep (SOREM) periods in the multiple sleep latency test (MSLT) supports the diagnosis of narcolepsy, but can also occur in other conditions with increased sleep pressure, including insufficient sleep syndrome or obstructive sleep apnea syndrome (OSAS). In addition, analysis of sleep stage sequence (SSS) allows differentiation between narcolepsy and other conditions with SOREMs. The aim of this study was to compare frequency and SSS of SOREMs in Parkinson's disease (PD), narcolepsy, and OSAS patients. Methods: Retrospective analysis of MSLT findings of 60 PD patients, 54 narcolepsy patients and 89 OSAS patients. Results: Five PD patients (8%) had 1 SOREMs, with 4 patients having 1 and 1 patient having 3 SOREMs. All narcolepsy patients had 1 SOREMs: 24 had 4 SOREMs, 17 had 3 SOREMs, 11 had 2 SOREMs. Nine-teen OSAS patients (21%) had 1 SOREMs: 3 had 3 SOREMs, 5 had 2 SOREMs, and 11 had 1 SOREM. In PD, the three most common SSS were N1_R (4/8 SOREMs), followed by N1_R_N2 (2/8 SOREMs) and N1_N2_R (1/8 SOREM). In narcolepsy, the three most common SSS were N1_R (67/172 SOREMs, 39%), N1_N2_R (50/172 SOREMs, 29%) and N1_R_N2 (41/172 SOREMs, 24%). In OSAS, the three most common SSS were N1_N2_R (26/30 SOREMs, 87%), N1_R_N2 (3/30 SOREMs, 10%) and N1_R (1/30 SOREMs, 3%). Conclusions: Compared to narcolepsy and OSAS, SOREMs are less frequent in PD, but their SSS is different from that of OSAS patients. P 1.044. REM SLEEP BEHAVIOUR DISORDER AND COGNITIVE FUNCTIONS IN PARKINSON'S DISEASE Elena Lyashenko 1, Oleg Levin 1, Mihail Poluektov 2. 1 Department of Neurology, RMAPE, Moscow, Russian Federation; 2 I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation Objectives: This study aimed to estimate cognitive functions of PD patients with RBD versus those without RBD and cognitive functions of RBD patients in connection with time of RBD onset (pre-PD, post-PD). Methods: 60 patients with PD were evaluated with detailed clinical history and examination (including polysomnography). Clinical exam included RBD screening questionnaire, UPDRS, H&Y, S&E scale and Montreal Cognitive Assessment (MoCA). Patients were divided into two groups (30 patients in RBD group and 30 patients in non-RBD group). RBD patients were divided into 2 groups - pre-PD (n¼17) and post-PD (n¼13). Groups
Abstracts / Parkinsonism and Related Disorders 22 (2016) e29ee75
Results: PDQ-39 had significantly correlated with GSRS items of diarrhea and constipation, PFS-16, BDI-II and PDSS. It is revealed that PFS-16, GSRS item of constipation and PDSS correlated with PDQ-39 by logistic regression analysis. PFS-16 had most significant correlation with PDQ-39 among those factors (p < 0.01). Conclusions: Bowel movement disorder, fatigue, depression, and sleep disturbance were correlated with QOL in de novo PD. Fatigue was, specifically, highly correlated with QOL in these factors. We should be aware of possibility of improvement of QOL by focusing on these symptoms. P 1.038. ASSESSING THE NON-MOTOR SYMPTOM BURDEN PROGRESSION IN A LONGITUDINAL STUDY OF 411 PARKINSON'S PATIENTS, USING THE NON-MOTOR SYMPTOM QUESTIONNAIRE Miguel Grilo 1, Dhaval Trivedi 1, Elisa Moti 1, Rui Barreto 1, Anna Sauerbier 2, Alexandra Rizos 1, Lauren Perkins 1, Rona Inniss 1, Theresa Chiwera 1, K. Ray Chaudhuri 2. 1 National Parkinson Foundation International Centre of Excellence, Department of Neurology, King's College Hospital, London, United Kingdom; 2 National Parkinson Foundation International Centre of Excellence, Department of Neurology, King's College Hospital, Maurice Wohl Clinical Neuroscience Centre, King's College, London, United Kingdom Objectives: Our aim was to evaluate in a holistic manner the progression of non-motor symptoms (NMS) burden in Parkinson's disease (PD) using validated NMS Questionnaire (NMSQuest) cut off scores (Chaudhuri K R et al, 2015). Methods: We reviewed the data of PD patients from a European longitudinal study and compared the NMS burden score at baseline, 12 and 24 months follow-up. Demographics and Hoehn and Yahr classification (HY) were collated for 411 patients. Results: Out of 411 patients (mean age 45.1±10.8 years, duration of disease 5.1±4.8 years, median HY¼2, 58.6% male), 60 were reassessed at 12 months and 40 at 24 months (figure 1). HY and NMSQuest burden scores showed a moderate correlation at baseline (rs(n¼411)¼0.389, p<0.0005). Comparison of NMSQuest burden score at baseline and at 12 and 24 months did not show significant median differences (z¼-1.278, p<0.061 and z¼-1.455, p<0.122, respectively). Patients with HY2 did not show significant differences between NMSQuest burden scores at follow up as well as those with HY>2 (HY2:z¼-0.555, p<0.184 and z¼-0.894; p<0.157; HY>2 z¼-0.970, p<0.185 and z ¼ -0.866, p<0.356, respectively). Conclusions: The preliminary results of this study are in line with studies reporting that patients might have a heterogeneous NMS burden despite disease evolution and motor staging. This emphasizes the importance of a regular assessment and revaluation of NMS.
Objectives: Parkinson's disease (PD) is a chronic and progressive neurological condition in which non-motor disturbances as well as motor deficits significantly impact quality of life. The objective of the study is aimed at exploring the quality of life of patients with PD, depending on gender, age, form of the disease and the severity of cognitive impairment. Methods: The study was conducted at Neurology Department, Tashkent Medical Academy. All patients with Parkinson's disease seen in a population based study on the prevalence of parkinsonism were asked to complete a disease-specific QoL questionnaire (PDQ-39). A structured questionnaire interview and a complete neurological examination, including the Hoehn and Yahr scale, the Schwab and England disability scale, the motor part of the unified Parkinson's disease rating scale (UPDRS part III), and the MMSE were performed by a neurologist. Results: The results have shown that between 2013-2014 here were 82 cases of PD, 55,6% of which were among female, 44,4-male,age categories: from 45 to 72 years. No significant differences were found in terms of the age and the sex of patients. Significant differences were found in the form of the disease, standard of living with a tremor form was lover than an akinetic and a mixed. The assessment of QoL depending on severity of cognitive impairment showed that patients with mild dementia have lower standard of living. Conclusion: Parkinson's disease restrict the quality of life in areas such as mobility, daily activities, disease symptoms, emotional and cognitive functions most of the patients feel lower quality of life. P 1.040. VALIDATION OF THE ITALIAN NON MOTOR SYMPTOMS QUESTIONNAIRE AND NON MOTOR SYMPTOMS SCALE FOR PARKINSON'S DISEASE Ilaria Cova 1, Nicola Vanacore 2, Patrizia Contri 1, Giuseppe Meco 3, Simone Pomati 1, Giulia Grande 1, Eleonora Lacorte 2, Alberto Priori 4, Claudio Mariani 1. 1 Department of Neurology, Luigi Sacco Hospital, University of Milan, Milan, Italy; 2 National Institute of Health, Rome, Italy; 3 Department of Neurological Sciences, Sapienza University, Rome, Italy; 4 Department of Neurology, San Paolo Hospital, University of Milan, Milan, Italy Objectives: To validate Italian version of Non Motor Symptoms Questionnaire (NMSQuest) and Non Motor Symptoms Scale (NMSS), tools for quantify and qualify non-motor symptoms in Parkinson's disease (PD). Methods: Ninety Italian PD1 outpatients will be asked to complete the Italian NMSQuest and NMSS. Mini-Mental Parkinson will be used to investigate cognitive disorders, Hamilton Rating Scale for depression and MDS-UPDRS for motor and non-motor assessment. NMSQuest and NMSS will be repeated in a subset of 20 PD patients after 1month to assess the reliability of non-motor symptoms. A correlation analysis between the scores of all scales and questionnaires used will be performed. The intraclass correlation index will be adopted to assess the reliability. A p value of 5% will be considered as statistically significant. Results: In a preliminary analysis on 21 PD patients (mean age 67.2±8.3
Hoehn and Yahr & NMSQuest Levels at Baseline (n¼411). NMSQuest Levels
HY
Total Number Total %
1.0 1.5 2.0 2.5 3.0 4.0 5.0
None
Mild
Moderate
Severe
Very Severe
2 1 2 2 2 0 0 9 2.2%
34 2 25 4 13 2 2 82 20.0%
24 3 31 6 40 8 3 115 28.0%
14 2 32 4 41 11 3 107 26.0%
6 0 16 6 39 23 8 98 23.8%
P 1.039. QUALITY OF LIFE IN PATIENTS WITH PARKINSON'S DISEASE IN UZBEKISTAN Mukhlisa Khanova 2, Oybek Navruza Tolibova 1, Turgunkhujaev 1. 1 Department of Neurology, Tashent Medical Academy, Tashkent, Uzbekistan; 2 Department of Neurology, Tashkent Pediatric Medical Institute, Tashkent, Uzbekistan
Total Number
Total %
80 8 106 22 135 44 16 411 100.0%
19.5% 1.9% 25.8% 5.4% 32.8% 10.7% 3.9% 100.0%
years; 33% females, disease duration 6.4±4.6 years),no statistical differences were found in comparison between patients with H&Y2 (n¼15) and H&Y3 (n¼6) in the total score of NMSQuest (9.1±6.3 vs. 10.5±4.4; p ¼ 0.61) and NMSS (41.9±53.3 vs. 38.0±20.8; p ¼ 0.86). Conclusions: In the preliminary analysis the Italian version of NMSQuest and of NMSS exhibited good reliability and validity for the assessment of non motor symptoms in Italian PD patients. This first analysis further outlines the importance of record non motor symptoms of PD even in early
Abstracts / Parkinsonism and Related Disorders 22 (2016) e29ee75
motor stage, in order to identify and manage non-motor symptoms in PD. References: 1. Gelb DJ, Oliver E, Gilman S. Diagnostic criteria for Parkinson's disease. Arch Neurol 1999;56:33-39. P 1.041. PARKINSON DISEASE NON-MOTOR PROFILE AND MAPT HAPLOTYPES Maria Elena Di Battista 1, Alfonso Rubino 1, Chiara Papi 1, Marcella Valente 2, Esterina Pascale 3, Carlo Purcaro 1, Giuseppe Meco 1. 1 Department of Neurology and Psychiatry (Parkinson's Centre), Sapienza University, Rome, Italy; 2 Research Centre of Social Diseases (CIMS), Sapienza University, Rome, Italy; 3 Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University, Rome, Italy Objectives: Given the convergent data indicating a role of MAPT in Parkinson's disease, we sought to explore the effect of MAPT background (H1/ H1 homozygous vs H2 carriers) in the whole spectrum of non-motor symptoms in a cohort of patients with idiopathic PD. Methods: One hundred and eleven PD patients without dementia were enrolled. Patients were assessed with the following scales: BDI for depressive symptoms; Montreal Cognitive Assessment (MOCA) for the evaluation of cognitive status and to exclude patients with severe cognitive dysfunctions; SCOPA-AUT to assess the wide spectrum of dysautonomic dysfunctions; Non Motor Symptoms Scale (NMSS) concerning frequency and severity of a wide range of NMS; Epworth Sleepiness Scale (EPSS) for sleep disturbance evaluation; Neuropsychiatric Inventory Scale (NPI) to assess the presence of psychotic symptoms. Results: H1 homozygous and H2 carriers were comparable with regard to age, age at onset and disease duration. No difference emerged in cognitive global efficacy (MOCA) or specific cognitive domain. Neuropsychiatric complaints and mood disorders were differently distributed across the two groups, as well as sleep disturbances. No difference was observed in the overall burden of non-motor symptoms assessed with SCOPA-AUT and NMSS. However, cardiovascular and thermoregulation dysfunctions were significantly associated with H1/H1 backgrounds in the subgroup of patients with akinetic-rigid motor phenotype. Conclusions: MAPT background did not impact the frequency and severity of non-motor symptoms in our cohort of PD patients without dementia. Cardiovascular and thermoregulation dysfunctions were significantly associated with H1 homozygosity only in the akinetic-rigid subgroup. P 1.042. SLEEP AND MOOD PREDICT QUALITY OF LIFE CHANGE IN PARKINSON'S DISEASE: A LONGITUDINAL STUDY Kumar M. Prakash 1, Nivedita Nadkarni 2, Weng-Kit Lye 2, Ming-Hui Yong 3, Eng-King Tan 1. 1 Department of Neurology, Singapore General Hospital, National Neuroscience Institute, Duke-NUS Graduate Medical School, Singapore, Singapore; 2 Centre for Quantitative Medicine, Duke-NUS Graduate Medical School, Singapore, Singapore; 3 Department of Neurology, Singapore General Hospital, Singapore, Singapore Objectives: Non-motor symptoms (NMS) are common among patients with Parkinson's disease (PD) however little is known about the influence of its burden on the health-related quality of life (QoL) over a defined follow-up period. Our study was aimed to establish the impact of NMS burden change on the change in QoL of patients with PD over a 2-year follow-up period. Methods: Newly referred PD patients were prospectively enrolled and followed-up for up to 24 months. Non-motor symptoms scale (NMSS) was used to evaluate the burden of NMS while QoL was assessed with the Parkinson's disease Questionnaire-39 items (PDQ-39). Motor disabilities were assessed using the Part III (motor) Unified Parkinson's Disease Rating Scale (UPDRSm). Results: The multivariate analysis showed that total NMS burden change significantly predicted the change in the QoL scores while motor scores did not. Among the various domains of NMS, domains 2 (sleep/ fatigue) and 3 (mood/ apathy) were most significantly predictive of QoL change. Conclusions: NMS burden changes, in particular sleep and mood, have significantly greater impact on the change in quality of life of Parkinson's disease patients over a 2-year follow-up period.
e39
References: 1. Barone P, Antonini A, Colosimo C, Marconi R, Morgante L, Avarello TP, et al., The PRIAMO study: A multicenter assessment of nonmotor symptoms and their impact on quality of life in Parkinson's disease. Mov Disord 2009;24:1641-1649. 2. Song W, Guo X, Chen K, Chen X, Cao B, Wei Q, Huang R, Zhao B, Wu Y, Shang HF. The impact of non-motor symptoms on the Health-Related Quality of Life of Parkinson's disease patients from Southwest China. Parkinsonism Relat Disord. 2014;20:149-152. ndez R. Impact of non-motor 3. Santos-García D, de la Fuente-Ferna symptoms on health-related and perceived quality of life in Parkinson's disease. J Neurol Sci. 2013;332;136-140. 4. Shearer J, Green C, Counsell CE, Zajicek JP. The impact of motor and non motor symptoms on health state values in newly diagnosed idiopathic Parkinson's disease. J Neurol. 2012;259:462-468. 5. Martinez-Martin P, Rodriguez-Blazquez C, Kurtis MM, Chaudhuri KR; NMSS Validation Group. The impact of non-motor symptoms on healthrelated quality of life of patients with Parkinson's disease. Mov Disord. 2011;26:399-406. P 1.043. FREQUENCY AND SLEEP STAGE SEQUENCE OF SOREM PERIODS IN PARKINSON'S DISEASE Tobias Murer 1, Esther Werth 2, Rositsa Poryazova 3, Yury Gavrilov 3, Daniel Waldvogel 3, Christian Baumann 3, Philipp Valko 3. 1 Department of Neurology, University Hospital Zurich, Zurich, Switzerland; 2 Department of Neurology, University Hospital Zurich, University Hospital Zurich, Switzerland; 3 Department of Neurology, University Hospital Zurich, Department of Neurology, University Hospital Zurich, Switzerland Objectives: The presence of multiple sleep onset REM sleep (SOREM) periods in the multiple sleep latency test (MSLT) supports the diagnosis of narcolepsy, but can also occur in other conditions with increased sleep pressure, including insufficient sleep syndrome or obstructive sleep apnea syndrome (OSAS). In addition, analysis of sleep stage sequence (SSS) allows differentiation between narcolepsy and other conditions with SOREMs. The aim of this study was to compare frequency and SSS of SOREMs in Parkinson's disease (PD), narcolepsy, and OSAS patients. Methods: Retrospective analysis of MSLT findings of 60 PD patients, 54 narcolepsy patients and 89 OSAS patients. Results: Five PD patients (8%) had 1 SOREMs, with 4 patients having 1 and 1 patient having 3 SOREMs. All narcolepsy patients had 1 SOREMs: 24 had 4 SOREMs, 17 had 3 SOREMs, 11 had 2 SOREMs. Nine-teen OSAS patients (21%) had 1 SOREMs: 3 had 3 SOREMs, 5 had 2 SOREMs, and 11 had 1 SOREM. In PD, the three most common SSS were N1_R (4/8 SOREMs), followed by N1_R_N2 (2/8 SOREMs) and N1_N2_R (1/8 SOREM). In narcolepsy, the three most common SSS were N1_R (67/172 SOREMs, 39%), N1_N2_R (50/172 SOREMs, 29%) and N1_R_N2 (41/172 SOREMs, 24%). In OSAS, the three most common SSS were N1_N2_R (26/30 SOREMs, 87%), N1_R_N2 (3/30 SOREMs, 10%) and N1_R (1/30 SOREMs, 3%). Conclusions: Compared to narcolepsy and OSAS, SOREMs are less frequent in PD, but their SSS is different from that of OSAS patients. P 1.044. REM SLEEP BEHAVIOUR DISORDER AND COGNITIVE FUNCTIONS IN PARKINSON'S DISEASE Elena Lyashenko 1, Oleg Levin 1, Mihail Poluektov 2. 1 Department of Neurology, RMAPE, Moscow, Russian Federation; 2 I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation Objectives: This study aimed to estimate cognitive functions of PD patients with RBD versus those without RBD and cognitive functions of RBD patients in connection with time of RBD onset (pre-PD, post-PD). Methods: 60 patients with PD were evaluated with detailed clinical history and examination (including polysomnography). Clinical exam included RBD screening questionnaire, UPDRS, H&Y, S&E scale and Montreal Cognitive Assessment (MoCA). Patients were divided into two groups (30 patients in RBD group and 30 patients in non-RBD group). RBD patients were divided into 2 groups - pre-PD (n¼17) and post-PD (n¼13). Groups