Non-Motor Symptoms of Amyotrophic Lateral Sclerosis: A Multi-Faceted Disorder

2021 ◽  
pp. 1-15
Author(s):  
Yuval Nash ◽  
Michal Sitty

Amyotrophic Lateral Sclerosis (ALS) is a fatal neurodegenerative disease characterized by progressive degeneration of motor pathways. A growing body of evidence from recent years suggests that ALS results in a wide range of non-motor symptoms as well, which can have a significant impact on patients’ quality of life. These symptoms could also, in turn, provide useful information as biomarkers for disease progression, and can shed insight on ALS mechanisms. Here we aim to review a wide range of non-motor symptoms of ALS, with emphasis on their importance to research and clinical treatment of patients.

2018 ◽  
Vol 18 (5) ◽  
pp. 399-406 ◽  
Author(s):  
Bhanu Ramaswamy ◽  
Julie Jones ◽  
Camille Carroll

Exercise is key to a healthy and productive life. For people with Parkinson’s, exercise has reported benefits for controlling motor and non-motor symptoms alongside the use of pharmacological intervention. For example, exercise prolongs independent mobility and improves sleep, mood, memory and quality of life, all further enhanced through socialisation and multidisciplinary team support. Recent research suggests that optimally prescribed exercise programmes following diagnosis may alter neurophysiological processes, possibly slowing symptom progression.Given its benefits, professionals should encourage and motivate people with Parkinson’s to exercise regularly from the time of diagnosis and provide guidance on what exercise to do. We provide examples of how the growing body of evidence on exercise for people with Parkinson’s is revolutionising the services they are provided. We also highlight new resources available to help the wider support network (people such as volunteers, partners and friends of people with Parkinson’s) with an interest in exercise promote a consistent message on the benefits of exercise.


2018 ◽  
Vol 18 (2) ◽  
pp. 63-71 ◽  
Author(s):  
A V Kudrevatykh ◽  
M D Didur ◽  
TV V Sergeev ◽  
D S Bug ◽  
I V Miliukhina

Aim of the study: to assess non-motor symptoms and quality of life in patients with essential tremor (ET), different stages of Parkinson’s Disease (PD) and combination of ET and PD (ET-PD). Materials and methods of the research: We examined 82 patients with ET, 20 patients with ET-PD, 283 patients with PD, and 72 neurologically healthy volunteers. The neuropsychological status, intensity of motor symptoms, the grade of vegetative dysfunction and dyssomnia, and quality of life of patients were assessed. Results: Patients with ET showed wide range of nonmotor symptoms. The severity of cognitive impairment in group of patients with ET corresponded with the same severity of patients with early stages of PD. It is interesting that patients with ET showed more severe depression than patients with early stages of PD. The maximum severity of anxiety-depressive disorders was observed in patients with the combination of ET-PD. Conclusion: In spite of the fact that it is usual to consider the ET as a monosymptomatic benign disease, we have found significant non-motor disorders in this group of patients and a significant violation of the quality of life. The results of the study also give evidence that patients with ET-PD represent a special group of patients, characterized by special, both motor and non-motor symptoms. The data we obtained made it possible to form a deeper understanding of the generality of the clinical manifestations of ET, PD and ET-PD, which will make it possible to improve the quality of management of patients with these nosologies in clinical practice.


2019 ◽  
Vol 10 (2) ◽  
pp. 66-73
Author(s):  
Vladislav B. Voitenkov ◽  
E. V. Ekusheva

In this review, we discuss different aspects of pain syndrome in patients with amyotrophic lateral sclerosis: etiology, incidence, pathophysiology and main clinical features. Also we review the modern approaches to the treatment of pain in amyotrophic lateral sclerosis. Pain is actually not rare in this condition: it appears in 80% of patients, affecting their quality of life and functional activity, leading to the development of depressive and anxiety disorders. Pain in amyotrophic lateral sclerosis is often overlooked by clinicians, since their attention may focus on the motor symptoms of the disease. Thus, a more careful approach is needed to diagnose and treat pain in amyotrophic lateral sclerosis.


2021 ◽  
pp. 1-15
Author(s):  
Eduardo Tolosa ◽  
Georg Ebersbach ◽  
Joaquim J. Ferreira ◽  
Olivier Rascol ◽  
Angelo Antonini ◽  
...  

Background: A greater understanding of the everyday experiences of people with Parkinson’s disease (PD) and their carers may help improve clinical practice. Objective: The Parkinson’s Real-world Impact assesSMent (PRISM) study evaluated medication use, health-related quality of life (HRQoL) and the use of healthcare resources by people with PD and their carers. Methods: PRISM is an observational cross-sectional study, in which people with PD and their carers completed an online survey using structured questionnaires, including the Parkinson’s Disease Quality of Life Questionnaire (PDQ-39), Non-Motor Symptoms Questionnaire (NMSQuest) and Zarit Burden Interview (ZBI). Results: Data were collected from 861 people with PD (mean age, 65.0 years; mean disease duration, 7.7 years) and 256 carers from six European countries. People with PD reported a large number of different co-morbidities, non-motor symptoms (mean NMSQuest score, 12.8), and impaired HRQoL (median PDQ-39 summary score, 29.1). Forty-five percent of people with PD reported at least one impulse control behaviour. Treatment patterns varied considerably between different European countries. Levodopa was taken in the last 12 months by 85.9% of participants, and as monotherapy by 21.8% . Carers, who were mostly female (64.8%) and the partner/spouse of the person with PD (82.1%), reported mild to moderate burden (mean ZBI total score, 26.6). Conclusions: The PRISM study sheds light on the lives of people with PD and those who care for them, re-emphasising the many challenges they face in everyday life. The study also provides insights into the current treatment of PD in Europe.


Author(s):  
Emily Beswick ◽  
Deborah Forbes ◽  
Zack Hassan ◽  
Charis Wong ◽  
Judith Newton ◽  
...  

Abstract Background Amyotrophic lateral sclerosis (ALS) is increasingly recognised as a multi-system disorder, presenting with common and impactful non-motor symptoms, such as neuropsychiatric symtpoms, cognitive and behavioural changes, pain, disordered sleep, fatigue and problematic saliva. Aim/hypothesis We aimed to systematically review 25 years of ALS clinical trials data to identify if non-motor features were evaluated, in addition to the traditional measures of motor functioning and survival, and where evaluated to describe the instruments used to assess. We hypothesised that assessment of non-motor symptoms has been largely neglected in trial design and not evaluated with ALS-suitable instruments. Methods We reviewed clinical trials of investigative medicinal products in ALS, since the licensing of riluzole in 1994. Trial registry databases including WHO International Trials Registry, European Clinical Trials Register, clinicaltrials.gov, and PubMed were systematically searched for Phase II, III or IV trials registered, completed or published between 01/01/1994 and 16/09/2020. No language restrictions were applied. Results 237 clinical trials, including over 29,222 participants, were investigated for their use of non-motor outcome measures. These trials evaluated neuropsychiatric symptoms (75, 32%), cognitive impairment (16, 6.8%), behavioural change (34, 14%), pain (55, 23%), sleep disturbances (12, 5%) and fatigue (18, 8%). Problematic saliva was assessed as part of composite ALS-FRS(R) scores in 184 trials (78%) but with no focus on this as an isolated symptom. 31 (13%) trials including 3585 participants did not include any assessment of non-motor symptoms. Conclusions Non-motor symptoms such as neuropsychiatric, cognitive and behavioural changes, pain, disordered sleep, fatigue, and problematic saliva have not been consistently evaluated in trials for people with ALS. Where evaluated, non-symptoms were primarily assessed using instruments and impairment thresholds that are not adapted for people with ALS. Future trials should include non-motor symptom assessments to evaluate the additional potential therapeutic benefit of candidate drugs. PROPSERO registration CRD42020223648.


2012 ◽  
Vol 18 ◽  
pp. S18
Author(s):  
D. Joshi ◽  
P. Chatterjee ◽  
B. Kumar ◽  
A.Z. Ansari ◽  
V.N. Mishra ◽  
...  

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