Characterization of Non‐Motor Fluctuations Using the Movement Disorder Society Non‐Motor Rating Scale. Issue 7 (5th August 2022)

• Record Type: Journal Article
• Authors: van Wamelen, Daniel Johannes; Rota, Silvia; Schrag, Anette; Rizos, Alexandra; Martinez‐Martin, Pablo; Weintraub, Daniel; Ray Chaudhuri, Kallol
• Is Part Of: Movement disorders clinical practice. Volume 9:Issue 7(2022)
• Page Start: 932
• Page End: 940
• Publication Date: 2022-08-05
• Subjects: Parkinson's disease -- non‐motor fluctuations -- non‐motor symptoms -- progression -- fluctuations -- wearable sensor; Movement Disorders; Movement disorders -- Periodicals; Movement disorders; Periodicals; Periodicals; 616
• DOI: 10.1002/mdc3.13520
• Languages: English
• ISSNs: 2330-1619

Abstract

Abstract: Background: Non‐motor fluctuations (NMF) in people with Parkinson's disease (PwP) are clinically important yet understudied. Objective: To study NMF in PwP using both the Movement Disorder Society Non‐Motor Rating Scale (MDS‐NMS) NMF subscale and wearable sensors. Methods: We evaluated differences in overall burden of NMF and of specific NMF across disease durations: <2 years (n = 33), 2–5 years (n = 35), 5–10 years (n = 33), and > 10 years (n = 31). In addition, wearable triaxial sensor output was used as an exploratory outcome for early morning "off" periods. Results: Significant between‐group differences were observed for MDS‐NMS NMF total scores ( P < 0.001), and specifically for depression, anxiety, fatigue and cognition, with both NMF prevalence and burden increasing in those with longer disease duration. Whereas only 9.1% with a short disease duration had NMF (none of whom had dyskinesia), in PwP with a disease duration of >10 years this was 71.0% ( P < 0.001). From a motor perspective, dyskinesia severity increased evenly with increasing disease duration, while NMF scores in affected individuals showed an initial increase with largest differences between 2–5 years disease duration ( P < 0.001), with plateauing afterwards. Finally, we observed that the most common NMF symptoms in patients with sensor‐confirmed early morning "off" periods were fluctuations in cognitive capabilities, restlessness, and excessive sweating. Conclusions: Non‐motor fluctuations prevalence in PwP increases with disease duration, but in a pattern different from motor fluctuations. Moreover, NMF can occur in PwP without dyskinesia, and in those with NMF the severity of NMF increases most during years 2–5 after diagnosis.