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    HALLUCINATION AND RISK FACTORS IN PATIENTS WITH PARKINSON’S DISEASE
    (2019) Say, Bahar; Ünal, Yasemin; Tunç, Tuğba; Ergun, Ufuk; Ergün, Ufuk
    Objective: Hallucination is one of the non-motor symptoms inParkinson disease (PD). Several factors may affect the presenceof hallucination. In the present study, we aimed to compare PDpatients presenting with and without hallucinations, to determinerisk factors, and to find out common hallucination types.Material and Methods: Idiopathic Parkinson patients regardingto UK Parkinson Disease Society Brain Bank with and withouthallucinations were compared. The patients with psychoticsymptoms due to metabolic, infectious, and structural causeswere excluded. Disease severity was evaluated by UnifiedParkinson Disease Rating Scale and Hoehn and Yahr staging.Cognitive status was assessed by Minimental State Examinationtest. Depression was diagnosed on the basis of DSM-V Tr.Description of hallucination, treatment, co-morbidity, sleepdisturbances, REM sleep behavioral disorder, age, gender,scores of test and scale, stage of disease were recorded.Results: A total of 91 (59 female, 32 male) patients withidiopathic PD were enrolled. The group with hallucinations(Group 1) had 40 (43.9%) patients and the one withouthallucinations (Group 2) had 51 (54.9%) patients. Total score ofUnified Parkinson Disease Rating Scale was significantly higherin Group 1 than Group 2 (37.83±16.65; 30.18±14.83; p=0.028).Sleep disturbances were high in Group 1 (n=24, 60%) whencompared to Group 2 (n=14, 27.4%) (p=0.007). The meanduration of hallucinations was 24.87±56.47 months in Group 1.Twenty-one patients (23.9%) had visual hallucinations; 15(16.5%) patients had illusions (minor hallucinations); and four(4.4%) patients had auditory hallucinations.Conclusion: Disease severity in Parkinson's disease may be afactor in the presence of hallucinations. Hallucinations may alsooccur with sleep disorders. Minor hallucinations are frequentlyobserved in early stages, with visual hallucinations being themost common hallucinations that may occur in every diseasestage.
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    The Impact of Prodromal Stage Non-Motor Symptoms on Clinical Progression in Parkinson’s Disease
    (2022) Say, Bahar; Ünal, Yasemin; Aksun, Zerin Özaydın; Yılmaz, Rezzak; Akbostancı, Cenk
    Objectives: Several non-motor symptoms (NMSs) were described in the prodromal Parkinson’s disease (PD). The aim of this study is to investigate the impact of the presence of prodromal NMSs on clinical progression of PD. Materials and Methods: We questioned the presence of NMSs in the prediagnostic stage in patients with PD. Group 1 reported at least one prodromal NMS and Group 2 reported no prodromal NMSs. As recommended by the Movement Disorder Society Task Force, the total likelihood ratios (LRs) of NMSs were calculated and correlated with disease progression. Clinical progression was determined by dividing the Unified Parkinson’s Disease Rating Scale Part III total score by the duration of the disease. Generalized linear model (GzLM) was used to determine associations between clinical progression rate and the predictor variables. Results: Group 1 had 48 patients (24 male, 24 female), and Group 2 had 46 patients (32 male, 14 female). Both groups were similar in terms of demographic and disease characteristics. Depression and constipation (for each symptom, 18 patients and 37.5%) were common in Group 1. The rate of clinical progression was higher in Group 1 than in Group 2 (p=0.037). There was no significant correlation between clinical progression rate and LRs of NMSs in Group 1 (rs=0.10, p=0.49). However, age of the diagnosis was the only significant factor associated with the clinical progression (p=0.69). Conclusion: Prodromal NMSs do not seem to impact the rate of disease progression, which may be explained by the non-dopaminergic and extra nigro-striatal pathway that cause NMSs.