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April 2020; 10 (2) The Nerve! Readers Speak

Reader response: Symptom burden among individuals with Parkinson disease: A national survey

Geke M. Overvliet, Roos E. Meijer van Dun, Indrag K. Lampe, Annemarie M. Vlaar
First published April 6, 2020, DOI: https://doi.org/10.1212/CPJ.0000000000000818
Geke M. Overvliet
(Amsterdam, the Netherlands)
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Roos E. Meijer van Dun
(Amsterdam, the Netherlands)
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Indrag K. Lampe
(Amsterdam, the Netherlands)
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Annemarie M. Vlaar
(Amsterdam, the Netherlands)
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Reader response: Symptom burden among individuals with Parkinson disease: A national survey
Geke M. Overvliet, Roos E. Meijer van Dun, Indrag K. Lampe, Annemarie M. Vlaar
Neurol Clin Pract Apr 2020, 10 (2) 90; DOI: 10.1212/CPJ.0000000000000818

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We read with great interest the study by Tarolli et al.,1 which explored the burden of disease in Parkinson disease (PD) by evaluating the prevalence of nonmotor symptoms and their association with quality of life. The authors selected nonmotor symptoms based on literature review, expert opinions, and patient interviews. We note that apathy, which has major consequences for patients and carers, was not included as a relevant nonmotor symptom in their study. We performed a subcohort analysis of 60 patients from a study of pain in PD in 110 outpatients (PaCoMo-study, registered trial number: NL6311402917 [toetsingonline.nl]). We retrospectively reviewed the medical records to check whether the clinician identified apathy in these patients in the previous year, which was the case in 15% of the patients (n = 9). Blind to those results, patients were examined with the Apathy Scale (AS).2 In total, 63.3% (n = 38) of the patients scored positive on the AS. Only 18.4% of the patients who scored positive on the AS were also classified or mentioned with apathy in the medical records by clinicians.

Apathy, an important nonmotor symptom of PD, is often missed or minimized by clinicians. When apathy is acknowledged, treatment can lead to better outcomes for patients.3

Footnotes

  • Author disclosures are available upon request (ncpjournal{at}neurology.org)

  • See response

  • © 2020 American Academy of Neurology

References

  1. 1.↵
    1. Tarolli CG,
    2. Zimmerman GA,
    3. Auinger P, et al
    . Symptom burden among individuals with Parkinson disease: a national survey. Neurol Clin Pract 2020;10:65–72.
    OpenUrlAbstract/FREE Full Text
  2. 2.↵
    1. Starkstein SE,
    2. Mayberg HS,
    3. Preziosi TJ,
    4. Andrezejewski P,
    5. Leiguarda R,
    6. Robinson RG
    . Reliability, validity, and clinical correlates of apathy in Parkinson's disease. J Neuropsychiatry Clin Neurosci 1992;4:134–139.
    OpenUrlCrossRefPubMed
  3. 3.↵
    1. Devos D,
    2. Moreau C,
    3. Maltête D, et al
    . Rivastigmine in apathetic but dementia and depression-free patients with Parkinson's disease: a double-blind, placebo-controlled, randomised clinical trial. J Neurol Neurosurg Psychiatry 2014;85:668–674.
    OpenUrlAbstract/FREE Full Text

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