Hallucinations/vivid dreams in Parkinson s Disease Patients. Preliminary results from the French PARKMIP/COPARK cohort study.

VALERIE COCHEN; LAURENCE NEGRE-PAGES; SANTIAGO PEREZ-LLORET; OLIVIER RASCOL

Paris, Francia

Congreso; Congreso Internacional de Movimientos Anormales; 2009

Objective: To assess the prevalence, associated factors and progression of HVD in thefirst 329 patients of the PARKMIP/COPARK cohort who reached the 24-month visit.Background: Hallucinations/vivid dreams (HVD) are common problems in Parkinson'sDisease (PD).Methods: Inclusion criteria: ambulatory outpatients randomly selected by 28neurologists, UKPDSBB diagnostic criteria, MMSE>24, no deep brain stimulation.Data collection: demographics, UPDRS and Hoehn & Yahr, antiparkinsonian treatments,anxiety and depression symptoms (HADS), sleep quality (PSQI) and quality of life(PDQ39). Presence of HVD was defined as UPDRS I item 2 1.Statistical analysis: bivariate and logistic regression analysis.Results: Data could be analyzed in 280 patients [49 could not be assessed at 24 monthbecause of death (19 cases) and UPDRS missing data (30 patients)]. At baseline72/280 patients (25%) had HVD. The main factors associated with the presence of HVDat baseline were: longer PD duration (p<0.0002), lower MMSE score (p<0.0001),greater UPDRS score and Hoehn & Yahr stage (p<0.001 for both), greater depressionscore (p<0.0005), worse PSQI score (p<0.02), longer duration and greater dose oflevodopa therapy (p<0.001), amantadine treatment (p<0.01) and poorer PDQ39 score(p<0.01). Logistic regression showed that PD duration > 5 years, MMSE 28 andpresence of depression symptoms (HADS > 7) were independently associated with thepresence of HVD (p<0.05 for all factors).At 24-month 98/280 patients (35%) had HDV. Sixty-five patients (23%) showed aworsening of HVD score after 24-months follow up. Patients with HVD score worseninghad higher frequency of depressive symptoms (p<0.001) and of cardiovascular disease(p<0.001) at baseline. The logistic regression analysis found that cardiovascular disease(OR= 2.1, 95%CI=1.2-3.8) and depressive symptoms (HADS-D > 7, OR= 2.9,95%CI=1.6-5.3) were independent predictors of HVD worsening.Conclusions: In the PARKMIP/COPARK PD cohort, 25% of the patients exhibitedhallucination/vivid dreams at baseline. After 2 years of follow-up 23% of the patientsshowed some deterioration in HVD score (UPDRS I item 2), which was associated witholder age and presence of depressive symptoms at baseline.