van Wamelen, Daniel J;
Rota, Silvia;
Schrag, Anette;
Rizos, Alexandra;
Martinez Martin, Pablo;
Weintraub, Daniel;
Chaudhuri, K Ray;
(2022)
Characterisation of non‐motor fluctuations using the Movement Disorder Society Non‐Motor Rating Scale.
Movement Disorders Clinical Practice
, 9
(7)
pp. 932-940.
10.1002/mdc3.13520.
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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.
| Type: | Article |
|---|---|
| Title: | Characterisation of non‐motor fluctuations using the Movement Disorder Society Non‐Motor Rating Scale |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1002/mdc3.13520 |
| Publisher version: | https://doi.org/10.1002/mdc3.13520 |
| Language: | English |
| Additional information: | © 2022 The Authors. Movement Disorders Clinical Practice published by Wiley Periodicals LLC. on behalf of International Parkinson and Movement Disorder Society. This is an open access article under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/). |
| Keywords: | Parkinson's disease, non-motor fluctuations, non-motor symptoms, progression, fluctuations, wearable sensor |
| UCL classification: | UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Clinical and Movement Neurosciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10152454 |
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