Triggers for the debut of a motor manifestation of Parkinson’s disease

A.V. Boiko


Background. Parkinson’s disease (PD) is one of the most frequent neurodegenerative diseases. In spite of the 200-year scientific study of PD, its etiology remains unknown until today. Earlier the latent and premotor phases were found to 4–10 years precede the development of the standard manifestations of PD. Triggers determination of clinical manifestation of PD motor symptoms is still an open question. The goal of the study is to determine the most frequent triggers of PD’s motor symptoms mani­festation through a questionnaire survey of patients. Materials and methods. One hundred and twenty PD patients were interviewed. The author designed questionnaire aimed to identify the factors provoking PD manifestation. There was a statistical analysis of clinical data and the results of the interview. The level of significance (p) sets at 0.05. Results. 53.33 % (64 patients) associated the development of PD motor symptoms with a previous significant acute psychotraumatic situation (distress). The time interval between the stress factors action and the debut of the dise­ase ranged from 1 day to 4 years (median (Me) 5.2 months; 95% CI 2.1–9.1 months). 3.33 % (4 people) noted acute respiratory infections at the time of PD manifestation or 2–4 months before the disease debut. 8.33 % (10 people) detected pain syndromes of varying localization. 35 % (42 respondents) noted the absence of triggers. Processing of clinical data (gender, age, PD debut and BP clinical forms structure) did not reveal any statistically significant differences between groups with different triggers for PD manifestation. Conclusions. Manifestation of PD motor symptom in some patients may be triggered by a number of factors, among which distress is. Further experiments have to verify author’s hypothesis of the formation of the absolute refractory area in dopaminergic system after stress exposure before the onset of PD motor symptoms.


Parkinson’s disease; manifestation; triggers


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