Affiliations: [a] Department of Neurosciences, Reproductive Sciences and Odontostomatology, Federico II University, Naples, Italy | [b] Paracelsus-Elena-Klinik, Klinikstraße 16, Kassel, Germany | [c] Department of Neurosurgery, University Medical Center Goettingen, Goettingen, Germany | [d] Department of Neuropathology, University Medical Center Goettingen, Goettingen, Germany | [e] Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, University College London, Queen Square, London, UK | [f] Department of Neurological and Movement Sciences, University of Verona, Verona, Italy | [g] Center for Neurodegenerative Diseases (CEMAND), Neuroscience Section, Department of Medicine, University of Salerno, Salerno, Italy | [h] Department of Primary Care and Public Health, Imperial College, South Kensington Campus, London, UK | [i] Department of Public Health, Federico II University, Naples, Italy
Correspondence to: Prof. Paolo Barone, Center for Neurodegenerative Disease–CEMAND, Neuroscience Section, Department of Medicine, University of Salerno, Via San Leonardo 1, 84131 Salerno, Italy. Tel./Fax: +39 0 89 672328; E-mail: email@example.com
Abstract: Background:Parkinson’s disease (PD) subjects are less likely to ever smoke and are more prone to quit smoking, as compared to controls. Therefore, smoking habits can be considered part of the non-motor phenotype, preceding the onset of motor PD by several years. Objective:To explore non-motor symptom (NMS) correlates of smoking habits in de novo PD. Methods:This cross-sectional study included 281 newly diagnosed, drug-naïve PD subjects, recruited in Naples (Italy) and in Kassel (Germany). All subjects completed the NMS Questionnaire (NMSQ), and were investigated for smoking status (never, current and former smokers) and intensity (pack-years). Results:140 PD subjects never smoked, 20 currently smoked, and 121 had quit smoking before PD diagnosis. NMSQ total score did not associate with smoking status, but with smoking intensity (p = 0.028; coefficient = 0.088). A multinomial logistic regression stepwise model presenting never smoking as reference, selected as NMSQ correlates of current smoking: sex difficulties (p = 0.002; OR = 5.254), daytime sleepiness (p = 0.046; OR = 0.085), insomnia (p = 0.025; OR = 0.135), and vivid dreams (p = 0.040; OR = 3.110); and of former smoking: swallowing (p = 0.013; OR = 0.311), nausea (p = 0.027; OR = 7.157), unexplained pains (p = 0.002; OR = 3.409), forgetfulness (p = 0.005; OR = 2.592), sex interest (p = 0.007; OR = 0.221), sex difficulties (p = 0.038; OR = 4.215), and daytime sleepiness (p = 0.05; OR = 0.372). An ordinal logistic regression stepwise model selected as NMSQ correlates of smoking intensity: nocturnal restlessness (p = 0.027; coefficient = 0.974), and leg swelling (p = 0.004; coefficient = 1.305). Conclusions:Certain NMSs are associated with different smoking status and intensity, suggesting a variety of adaptive mechanisms to cigarette smoking.
Keywords: Parkinson, de novo, non-motor, smoking, nicotine, cigarette, motor