1Division of Neurology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
2The Mah Pooi Soo & Tan Chin Nam Centre for Parkinson’s Disease and Related Disorders, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
3Aab Cardiovascular Research Institute (CVRI), University of Rochester Medical Center, Rochester, NY, USA
4Institute for Advanced Studies, University of Malaya, Kuala Lumpur, Malaysia
5Neurology Unit, Department of Medicine, Faculty of Medicine, The National University of Malaysia, Kuala Lumpur, Malaysia
6Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
7School of Pharmacy, Monash University Malaysia, Selangor, Malaysia
8Division Gasteroenterology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
Copyright © 2022 The Korean Movement Disorder Society
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Conflicts of Interest
The authors have no financial conflicts of interest.
Funding Statement
This work was supported by the Ministry of Higher Education, Malaysia Fundamental Research Grant Scheme (FRGS) FRGS/1/2018/SKK02/UM/02/1 (to AHT), and a generous donation from the family of Mdm. Chong Fong Chee.
Author Contributions
Conceptualization: Ai Huey Tan, Shen-Yang Lim. Data curation: Jia Wei Hor, Ai Huey Tan, Kah Kian Chong, Eng Soon Khor. Formal analysis: Jia Wei Hor, Ai Huey Tan. Funding acquisition: Ai Huey Tan. Investigation: Jia Wei Hor, Ai Huey Tan, Shen-Yang Lim, Kah Kian Chong, Eng Soon Khor, Norlinah Mohamed Ibrahim. Supervision: Ai Huey Tan, Chun Wie Chong, Sze Looi Song, Cindy Shuan Ju Teh. Visualization: Jia Wei Hor, Ai Huey Tan, Chun Wie Chong. Writing—original draft: Jia Wei Hor, Ai Huey Tan, Shen-Yang Lim. Writing—review & editing: Ai Huey Tan, Shen-Yang Lim, Ida Normiha Hilmi, Norlinah Mohamed Ibrahim, Chun Wie Chong, Sze Looi Song, Cindy Shuan Ju Teh.
PD (n = 71) | MSA (n = 38) | Controls (n = 60) | p-value | |||
---|---|---|---|---|---|---|
Age, yr | 67.8 ± 7.3 | 62.7 ± 7.8 | 64.3 ± 6.8 | 0.001*† | ||
Sex, % | ||||||
Male | 69.0 | 36.8 | 50.0 | 0.004*‡ | ||
Ethnicity, % | 0.048*‡ | |||||
Malay | 9.9 | 7.9 | 3.3 | |||
Chinese | 74.6 | 92.1 | 88.3 | |||
Indian | 15.5 | 0.0 | 8.3 | |||
Smoking status, % | 0.233‡ | |||||
Current smoker | 2.8 | 2.6 | 3.3 | |||
Past smoker | 32.4 | 21.1 | 16.7 | |||
Never smoked | 64.8 | 76.3 | 80.0 | |||
Body mass index, kg/m2 | 23.6 ± 3.9 | 21.8 ± 5.0 | 24.9 ± 4.2 | 0.003*† | ||
Comorbidities, % | ||||||
Diabetes mellitus | 16.9 | 5.4 | 20.0 | 0.141‡ | ||
Hypertension | 31.0 | 16.2 | 43.9 | 0.019‡ | ||
Ischemic heart disease | 11.3 | 13.2 | 14.0 | 0.891‡ | ||
Stroke | 2.8 | 8.1 | 1.8 | 0.244‡ | ||
Cancer | 2.8 | 10.8 | 1.8 | 0.076‡ | ||
Gastrointestinal symptoms | ||||||
PAC-SYM score (0–36) | 5.5 [6] | 8.0 [10.0] | 1.0 [4.0] | < 0.001*§ | ||
Less than 3 bowel movements per week, % | 90.1 | 63.2 | 20.0 | < 0.001*‡ | ||
Cognitive function | ||||||
MoCA score (0–30) | 25.0 [7.0] | 24.5 [9.0] | 27.0 [4] | < 0.001*§ | ||
Disease duration, onset & LEDD | ||||||
Disease duration, yr | 10.0 [10.0] | 3.75 [4.0] | < 0.001*§ | |||
Age of onset, yr | 57.9 ± 10.0 | 59.1 ± 8.1 | 0.535† | |||
LEDD, mg/d | 600.0 [475.0] | 300.0 [431.0] | < 0.001*§ | |||
PD severity and subtype | ||||||
Motor subtype, % | - | - | ||||
Tremor dominant | 19.4 | - | - | |||
Indeterminate | 11.9 | - | - | |||
PIGD | 68.7 | - | - | |||
MDS-UPDRS part III | 30.0 ± 13.3 | - | - | |||
MDS-UPDRS total | 60.7 ± 21.9 | - | - | |||
Hoehn & Yahr | 2.0 [1.0] | - | - | |||
With motor response complications∥, % | 26.1 | - | - | |||
MSA severity and subtype | ||||||
MSA subtype, % | - | - | ||||
MSA-P (predominant parkinsonism) | - | 57.9 | - | |||
MSA-C (predominant cerebellar) | - | 34.2 | - | |||
MSA-PC (mixed) | - | 7.9 | - | |||
UMSARS (total of parts I and II) | - | 57.2 ± 18.3 | - | |||
Hoehn & Yahr | - | 4.0 [1.0] | - |
Normally distributed data are presented as the mean ± standard deviation, while nonnormally distributed data are presented as the median [interquartile range].
* significant difference between groups;
† analyzed using one-way analysis of variance (ANOVA);
‡ analyzed using chi-square test;
§ analyzed using Kruskal-Wallis test;
∥ score of MDS-UPDRS part IV of one or more.
PD, Parkinson’s disease; MSA, multiple system atrophy; LEDD, levodopa equivalent daily dose; MDS-UPDRS, International Parkinson and Movement Disorder Society-Unified Parkinson’s Disease Rating Scale; UMSARS, Unified Multiple System Atrophy Rating Scale; MoCA, Montreal Cognitive Assessment; PAC-SYM, Patient Assessment of Constipation Symptoms; PIGD, postural instability gait disorder.