1.Non-motor symptoms in Thai Parkinson’s disease patients and the correlation with motor symptoms
Pawut Mekawichai ; Salintip Kunadisorn ; Chaiwiwat Tungkasereerak ; Surin Saetang
Neurology Asia 2016;21(1):41-46
Background and objective:to identify the prevalence of non-motor symptoms (NMS) and to determine the
association between NMS and motor symptoms in Thai Parkinson’s disease (PD) patients. Methods: A cross
sectional study was performed in PD patients at Maharat Nakhon Ratchasima Hospital between January-June
2014. The NMS were assessed by using Non-Motor Symptoms Questionnaire-Thai version. All data were
analyzedfor identifying the prevalence of NMS and determining the correlation between NMS and motor
symptoms. Results:One hundred thirty six PD patients were enrolled. The severity of disease according to
Modified Hoehn and Yahr (MHY) was 1-1.5=33.1% of the patients, 2-2.5=52.2% and 3-5=14.7%. All patients
(100%) had NMS with mean number of 13.2±6.7 symptoms (ranging from 1-29). Nocturia was the commonest
symptom (82.4%), followed by constipation (74.3%) and forgetfulness (69.9%). Bowel incontinence was
the least frequent symptom (19.9%). Sleep disorder was the mostprevalent domain (92.6%), followed by
digestive domain (91.9%) and urinary domain (89.0%). The number of NMS significantly increased with
the degree of severity of disease and was higher in patients with motor complications.
Conclusion:NMS were reported by every Thai PD patients, and at all stage of the disease. Nocturia symptom
and sleep disorder domain were the most frequent NMS. The number of NMS strongly correlated with
motor complications and the severity of motor symptoms. However the presence of motor complications
appears to have stronger association with some NMS domains than the motor severity
Parkinson Disease
2.Comparison of clinical features between aquaporin-4 antibody seropositive and seronegative patients in neuromyelitis optica and neuromyelitis optica spectrum disorder
Salintip KUNADISON ; Chaiwiwat TUNGKASEREERAK ; Surin SAETANG ; Pawut MEKAWICHAI
Neurology Asia 2018;23(1):55-59
Background & Objective: To evaluate the prevalence of aquaporin-4 antibody (AQP-4 Ab) seropositive patients in neuromyelitis optica (NMO) and neuromyelitis optica spectrum disorder (NMOSD) and to compare the clinical, investigation features and treatment outcome between the AQP-4 Ab seronegative and seropositive groups. Methods: All NMO and NMOSD patients in Maharat Nakhon Ratchasima hospital during January 2012 to December 2016 were recruited. Demographic, clinical, laboratory and imaging data were collected from the medical records. All data were analysed and compared between seropositive and seronegative groups as appropriates. Results: There were 12 (29%) and 30 (71%) NMO and NMOSD patients, respectively. There were 30 (71%) patients who hadAQP-4 Ab seropositive status. Thirty-three (78.6%) patients were female. In seropositive group, there were significantly higher proportion of female patients (87% versus 58%, p=0.04), immunosuppressant treatment (33% versus 0%, p=0.04), patients who had serum albumin less than 4 g/dL (46% versus 0%, p=0.02), cerebrospinal fluid (CSF) pleocytosis (71% versus 17%, p=0.01) and patients with extensive spinal cord involvement (67% versus 25%, p<0.05) than seronegative group. CSF-serum glucose ratio was significantly lower in seropositive group than seronegative group (0.5 + 0.03 versus 0.7 + 0.04, p=0.01). Conclusion: The prevalence of AQP-4 Ab seropositive patients in NMO and NMOSD was 71%. There were significantly more female patients, immunosuppressant treatment, patients with serum albumin less than 4 g/dL, CSF pleocytosis, low CSF-serum glucose ratio and extensive transverse myelitis than seronegative group.