The PRIAMO study: urinary dysfunction as a marker of disease progression in early Parkinson's disease

M. Picillo, R. Palladino, P. Barone, R. Erro, C. Colosimo, R. Marconi, L. Morgante, A. Antonini, the PRIAMO Study Group

Research output: Contribution to journalArticle

Abstract

Background and purpose: New venues are currently being explored to predict disease progression in Parkinson's disease (PD), such as non-motor subtypes and models merging motor and non-motor symptoms (NMS). By involving a subgroup of 585 patients from the PRIAMO (Parkinson Disease Non-motor Symptoms) study, the present 24-month longitudinal prospective analysis aimed to demonstrate that urinary dysfunction is an early marker of higher motor and non-motor burden as well as lower health-related quality of life. Methods and results: Multivariable mixed-effect logistic regression models controlling for demographic and clinical variables showed that the following NMS domains were associated with urinary dysfunction: gastrointestinal [odds ratio (OR) 2.57, 95% confidence interval (CI) 1.67–3.97, P < 0.001], cardiovascular (OR 2.22, 95% CI 1.18–4.17, P = 0.013), skin (OR 1.81, 95% CI 1.06–3.08, P = 0.029), sleep (OR 2.06, 95% CI 1.34–3.16, P = 0.001), pain (OR 1.85, 95% CI 1.21–2.83, P = 0.004), fatigue (OR 2.40, 95% CI 1.56–3.68, P < 0.001), apathy (OR 2.79, 95% CI 1.72–4.52, P < 0.001) and respiratory (OR 1.82, 95% CI 1.02–3.23, P = 0.039). Analysis also demonstrated that urinary dysfunction was associated with higher motor disability (coefficient 1.73, 95% CI 0.68–2.78, P = 0.001) and lower health-related quality of life (coefficient −0.05, 95% CI −0.08 to −0.02, P < 0.001, and coefficient −3.49, 95% CI −5.21 to −1.77, P < 0.001) but not with more severe cognitive disability (coefficient −0.34, 95% CI −0.92 to 0.24, P = 0.251). Conclusions: This is the first prospective longitudinal study involving a large cohort of PD patients demonstrating the relevance of urinary dysfunction as an early marker of higher motor and non-motor disability as well as lower health-related quality of life. These findings support a role for urinary dysfunction as an early marker of more severe disease progression.

Original languageEnglish
Pages (from-to)788-795
Number of pages8
JournalEuropean Journal of Neurology
Volume24
Issue number6
DOIs
Publication statusPublished - Jun 1 2017

Keywords

  • motor
  • movement disorders
  • non-motor
  • Parkinson
  • phenotype
  • PRIAMO
  • progression
  • urinary

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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    Picillo, M., Palladino, R., Barone, P., Erro, R., Colosimo, C., Marconi, R., Morgante, L., Antonini, A., & the PRIAMO Study Group (2017). The PRIAMO study: urinary dysfunction as a marker of disease progression in early Parkinson's disease. European Journal of Neurology, 24(6), 788-795. https://doi.org/10.1111/ene.13290