Abstract
We describe excessive buccal saliva (EBS) prevalence in patients with Parkinson’s Disease (PD) and controls of the COPARK study, its changes between “ON” and OFF” conditions and over time, its impact on Health-related Quality of life (HRQoL), and factors associated with this condition. We studied 671 ambulatory PD patients and 177 age/sex-matched controls. We defined “sialorrhea” as UPDRS item #6 (salivation) = 1 or 2; and “drooling” as item #6 = 3 or 4. SCOPA-Aut drooling score (item #2) was also available in a subset (45%) of the cohort. HRQoL was assessed by the PDQ-39 and SF-36 scales. Twenty-four months’ follow-up data were available in 401/671 patients. EBS as assessed by UPDRS was present in 38% of PD patients in the “ON” condition (“Sialorrhea”: 35%; “drooling”: 3%). There were also more PD patients reporting “drooling” than controls according to the SCOPA-Aut (49% vs 19%, p < 0.01). UPDRS salivation score was worse in the “OFF” vs “ON” condition in PD patients with motor fluctuations (0.90 ± 0.94 vs 0.54 ± 0.79, p < 0.01). UPDRS salivation score worsened after ~ 24 months of follow-up (0.47 ± 0.70 vs 0.64 ± 0.81, p < 0.01). Worse PDQ-39 scores were observed in PD patients with EBS in bivariate but not in multivariate analyses. EBS was directly related to PD duration and severity, male gender, dysphagia, hypomimia, and autonomic dysfunction (logistic regression). EBS was more frequent in PD patients than controls, worsened in the “OFF” condition and after ~ 24 months of follow-up, moderately affected HRQoL, and was correlated with indices of bradykinesia, dysphagia, and autonomic dysfunction.
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21 October 2020
The original version of this article unfortunately contained a mistake in Fig. 2 caption.
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Acknowledgements
The authors thank the patients who agreed to participate in this study and the Association France Parkinson for its support. COPARK study group: Dr F Tison (Bordeaux), Dr E Gaujard, Dr E Puymirat, Dr A Lanusse, Dr C Delabrousse-Mayoux, Dr E Goumard, Dr MH Godin, Dr P Damier (Nantes), Dr P Lejeune, Dr B Philippe, Dr C Lanctin-Garcia, Dr V Verbist-Talmant, Dr Rascol (Toulouse), Dr B Robinson, Dr V Rey-Zermati (Narbonne), Dr X Soulages (Rodez), Dr C Azais-Vuillemin (Toulouse), N Stambouli (Cahors), Dr JR Rouane (Toulouse), Dr AM Salandini (Toulouse), D JM Boulesteix (Cahors), Dr M Barreda (Castres), Dr D Castan (Castres), Dr A Ojero-Senard (Toulouse), Dr S Perez-Lloret (Toulouse), Dr G Angibaud (Montauban), Dr JP Balague (Montauban), Dr A Danielli (Montauban), Dr K Attane (Carcasonne), Dr JM Faucheux (Castres), Dr P Henry (Toulouse), Dr MG Rougie (Toulouse), Dr R Darmanaden, Dr B Jardillier (Figeac), Dr F Bonenfant (Toulouse), Dr Azais (Toulouse), Dr Damase (Toulouse), Dr A Destee (Lille).
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The project was co-funded by unrestricted and unconditional grants from the Association France-Parkinson, ADREN, Boehringer Ingelheim, Eisai, Faust Pharmaceuticals, GlaxoSmithKline, Pierre Fabre Médicaments, Solvay Pharma, Wyeth Lederlé. The project was sponsored and co-financed by LN PHARMA, which participated in the design and conduct of the study; collection, management, and interpretation of the data; and preparation and review of the manuscript.
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Olivier Rascol has acted as a scientific advisor for drug companies developing antiparkinsonian medications (Abbott, Abbvie, Acorda, Adamas, BIAL, Biogen, Boehringer-Ingelheim, Cynapsus, GSK, Impax, Merck, Osmotica, Merz pharmaceuticals, Oxford-Biomedica, Lundbeck, Novartis, Prexton, Servier, Sunovion, TEVA, UCB, Zambon) and has received unrestricted scientific grants from academic non-profit entities (Toulouse University Hospital, French Health Ministry, MJFox Foundation, France-Parkinson, European Commission). Laurence Negre-Pages reports grants from the Association France-Parkinson, ADREN, Boehringer Ingelheim, Eisai, Faust Pharmaceuticals, GlaxoSmithKline, Pierre Fabre Médicaments, Solvay Pharma, Wyeth Lederlé for funding this project and that she owns stock options from LN PHARMA, which was one of the sponsors of this study. Philippe Damier has received honoraria for conferences from Teva and Novartis. Wassilios Meissner has received fees for editorial activities from Springer Nature and Elsevier, for consultancy activities from Biohaven and Lundbeck, and teaching honoraria from UCB and Boehringer Ingelheim. Santiago Perez-Lloret received honoraria from Osmotica and Merz pharmaceuticals. Arnaud Delval, Pascal Derkinderen, Alain Destée, Margherita Fabbri, Amine Rachdi, and Francois Tison have no conflict of interest to declare.
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Rascol, O., Negre-Pages, L., Damier, P. et al. Excessive buccal saliva in patients with Parkinson’s disease of the French COPARK cohort. J Neural Transm 127, 1607–1617 (2020). https://doi.org/10.1007/s00702-020-02249-0
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DOI: https://doi.org/10.1007/s00702-020-02249-0