Clinical Predictors of disease progression in Parkinson's disease

Zhu, K. (2017)

Doctoral Thesis

In this thesis, longitudinal analyses have been performed on the PROPARK-Cohort, a
hospital-based cohort of 421 patients followed for a period of five years. The main focus of
this thesis was to determine which predictors and associated factors contributed to the
development of certain non-motor symptoms in Parkinson’s disease (PD). Strengths of our
cohort study include the length of the follow-up period, broad clinical characterization, limited
loss-to-follow-up and the large cohort size. The following non-motor symptoms have been
addressed in this thesis: psychosis (hallucinations), dementia, excessive daytime
sleepiness (EDS), insomnia, depression and anxiety. We found that while certain non-motor symptoms are inherent components of PD that increase in severity as the disease progresses, others symptoms such as excessive daytime sleepiness are inarguably caused by antiparkinsonian medication. For the future, we hope to see more longitudinal data on the
disease progression in PD from large cohorts. Knowledge from longitudinal
studies does not only contribute to more insight in the underlying pathobiology of PD, but it
could also help the caregiver to monitor patients with particular risk factors more closely and
adjust treatment if necessary.

• Parkinson's disease
• Non-motor symptoms
• Predictors
• Dementia
• Psychosis
• Depression
• Sleeping disorders

• All authors: Zhu, K.
• Supervisor: Hilten, J.J. van
• Co-supervisor: Marinus, J.M.
• Committee: Roos, R.A.C.; Berendse, H.W.; Boon, A.J.W.
• Qualification: Doctor (dr.)
• Awarding Institution: Medicince, Leiden University Medical Center (LUMC), Leiden University
• Date: 2017-11-22
• Sponsorship: - UCB Pharma - Vakgroep neurologen, Reinier de Graaf Groep - Parkinson Vereniging