Şakir DELİL1, Gülçin BENBİR1, Hülya APAYDIN1, Sibel ÖZEKMEKÇİ1, Ethem ERGİNÖZ5

1İstanbul Üniversitesi Cerrahpaşa Tıp Fakültesi Nöroloji Anabilim Dalı, İSTANBUL
2İstanbul Üniversitesi Cerrahpaşa Tıp Fakültesi Nöroloji Anabilim Dalı, İSTANBUL
3İstanbul Üniversitesi Cerrahpaşa Tıp Fakültesi Nöroloji Anabilim Dalı, İSTANBUL
4İstanbul Üniversitesi Cerrahpaşa Tıp Fakültesi Nöroloji Anabilim Dalı, İSTANBUL
5İstanbul Üniversitesi Cerrahpaşa Tıp Fakültesi Halk Sağlığı Anabilim Dalı, İSTANBUL

Keywords: Parkinson's disease, age at onset, first symptom localization, tremor, bradykinesia


Scientific Background: ldiopathic Parkinson's disease (PD) constitutes the most common form of all parkinsonism cases. ldiopathic PD usually begins in one half of the body, and generally in the upper extremity. Although both sides of the body are affected as disease progresses, the asymmetric features are preserved through the course of PD. Objectives: in this study, it was aimed to summarize the data bank obtained from 647 patients with PD followed up far nearly 10 years and compare the demographic characteristics with those of classically known PD features.
Material and Mhods: In this retrospective study, 647 patients admitted to our Movement Disorders Unit between January, 1990 - July, 2001 were included; and age of onset, type and the side of the initial symptom were studied. In addition, population were divided into two groups according to the first symptom being tremor or bradykinesia, and parameters including age at onset of PD symptoms, Hoehn & Yahr (H&Y) and Unified Parkinson Oisease Rating Scale (UPDRS) scores were compared between two groups using chi-square test. Results: About 56.1 % were men, while 43.9% were women, with a mean age of onset of 58. 9± 11.3 years. The mean duration of disease was found as 6.5±5.0 years. First symptom was tremor in 70% of the patients, bradykinesia in 27.4%, tremor and bradykinesia in 2.6%. The side of first semptom was on the right in 52%, bilateral in 7% of all patients; with 76.9% being on the upper extremity (p<0.001). The age at onset was found 59.7+ 11.2 years in tremor-onset group, and 57.6+ 11.1 years in bradykinesia-onset group (p=0.04). The mean H&Y stage was lower in tremor-onset group than the other group (p=0.02). The mean total and subset III UPORS scores, on the other hand, did not show significant difference in regard to first symptom. Conclusions: In this hospital-based study, we observed that PD affects men with slight preponderance, first symptom starts on the right side, and the upper extremity, with an earlier onset and a more progressive course in bradykinesia-onset group. Further long-term and more comprehensive epidemiologic studies have important position to explore the demographic features and the characteristics of PO patients in Turkish population.