Identification of wearing-off manifestations (reduction of levodopa effect) in Parkinson's disease using specific questionnaire and comparison of the results with routine ambulatory evaluations

Melo, Luciano Magalhães; Chien, Hsin Fen; Barbosa, Egberto Reis

doi:10.1590/s0004-282x2010000400007

Cited by 11 publications

(12 citation statements)

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“…The most common WO symptoms were motor symptoms, especially those correlated with bradykinesia (slowness, reduced dexterity) followed by tremor; among the non-motor symptoms the most frequent were the psychiatric ones, and these results are consistent with previous reports [14,20,21]. In accordance with other studies [14,22] we found a higher prevalence of fluctuating symptoms in subjects with longer disease duration, levodopa therapy, longer duration of levodopa therapy, more severe disease and in female gender ( Table 1).…”

Section: Discussionsupporting

confidence: 92%

Wearing-off detection in clinical practice: The wearing off real practice key (WORK-PD) study in Parkinson's disease

Altavista¹,

Cassetta²,

Brusa³

et al. 2015

Parkinsonism & Related Disorders

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Section: Discussionsupporting

confidence: 92%

Wearing-off detection in clinical practice: The wearing off real practice key (WORK-PD) study in Parkinson's disease

Altavista¹,

Cassetta²,

Brusa³

et al. 2015

Parkinsonism & Related Disorders

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“…In this analysis, we examined what aspects of off periods individuals with PD indicate as most bothersome and whether these would be captured by the WOQs, tools commonly used to screen for wearing off but also used to describe the spectrum of off symptoms in PD . In almost half of the responses, ≥1 most bothersome symptoms reported by patients would not be captured by the WOQs.…”

Section: Discussionmentioning

confidence: 99%

“…The WOQ‐32 was qualified as “suggested” as a screening tool for wearing off. However, the WOQs have been used in several studies to quantify symptom burden and examine the relationship between off symptoms, disease severity, and QOL . There are few data on the utility of the WOQs for the purpose of assessing the frequency and impact of different off symptoms.…”

mentioning

confidence: 99%

“…However, the WOQs have been used in several studies to quantify symptom burden and examine the relationship between off symptoms, disease severity, and QOL. 2,4,11,12 There are few data on the utility of the WOQs for the purpose of assessing the frequency and impact of different off symptoms. The degree to which these scales capture the symptoms most bothersome to patients is also not clear.…”

mentioning

confidence: 99%

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The Most Bothersome Aspects of Off Periods Reported by Individuals with Parkinson's Disease

Chahine

Edison

Daeschler

et al. 2020

Movement Disord Clin Pract

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Introduction The off periods in Parkinson's disease have a significantly negative impact on quality of life. What the most bothersome aspects of off periods are from the patient's perspective are not well studied, nor is the degree to which screening tools for wearing off such as the Wearing Off Questionnaires (WOQs) capture what bothers patients most. Methods A questionnaire was deployed to eligible participants of Fox Insight, an online study of individuals with self‐reported Parkinson's disease. Inclusion criteria were the use of ≥1 dopaminergic medications and an affirmative response to a question on experiencing off periods. Participants provided free‐text responses regarding the top 3 most bothersome symptoms they experience when off. A determination was made regarding whether each response would have been captured by the 32‐item, 19‐item, and 9‐item WOQs. Results The final sample had 2106 participants, a mean age of 66.6 years, 52.3% were men, and had a disease duration of 4.9 years. The WOQ‐32 items covered all of the most bothersome symptoms for 53.2% of respondents. Among bothersome aspects of off not captured by the WOQs, 597 (66.2%) were specific symptoms, with freezing of gait, apathy, and memory problems being the most common. The functional consequences of off periods were most bothersome to 232 (25.7%), with walking problems being the most common. The emotional response to off periods was the most bothersome aspect to 169 respondents (18.7%). Discussion This study emphasizes the value of narrative data in understanding patient experiences, and what bothers patients most about off periods. The WOQs, although of established utility in the screening for wearing off, may not capture those symptoms most bothersome to patients.

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“…Another study was conducted in the same institution in order to analyze the applicability of WOQ-19. Although, its methodology allowed achieving a larger sample size, since the questionnaire was read for the patients and the answers registered by the researcher 25 . The average schooling of eight years is similar to other studies conducted in developed countries 23,26 .…”

Section: Discussionmentioning

confidence: 99%

Specificity and sensibility of 9-Itens Wearing-off Questionnaire in Brazilian Parkinson disease patient sample

Santos

Chien

Barbosa

2014

Arq. Neuro-Psiquiatr.

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Objective: (1) To evaluate whether the Nine Items Questionnaire (WOQ-9) for the detection of wearing-off (WO) in Parkinson Disease (PD), by means of its screening ability, is a helpful tool to assist neurologists in diagnosing WO; (2) To determine the sensitivity and the specificity of a free Brazilian Portuguese translation of WOQ-9. Method: A sample obtained by convenience included 60 patients. The WOQ-9 was answered by the patients themselves before their routine consultations. The detection of the WO by the WOQ-9 was compared with the neurologist assessment. Statistical significance was 5%. Results: The WOQ-9 showed sensitivity of 100%, specificity of 10.3%, positive and negative predictive values of 54.4% and 100% respectively. The identification of WO by the WOQ-9 was congruent in 54.5% of cases with neurological evaluation. Conclusion: The WOQ-9 is a convenient screening tool to aid physicians to detect WO in PD patients, and it is a quick and easy self-administered questionnaire.Keywords: Parkinson's disease, levodopa, wearing-off, questionnaire. RESUMOObjetivo: (1) Verificar se o Questionário de Nove Itens (WOQ-9) para detectar wearing-off (WO) na doença de Parkinson (DP), pela sua capacidade de triagem, seria útil aos neurologistas na identificação de WO; (2) determinar a sensibilidade e especificidade da versão livre em Português Brasileiro do WOQ-9. Método: Ao todo 60 indivíduos com DP compuseram uma amostra obtida por conveniência. Os próprios pacientes responderam ao WOQ-9 antes de suas consultas rotineiras. A detecção de WO pelo WOQ-9 foi comparada com a avaliação neurológica. A significância estatística foi 5%. Resultados: O WOQ-9 apresentou sensibilidade de 100%, especificidade de 10,3%, valores preditivos positivo e negativo de 54,4% e 100% respectivamente. A identificação de WO pelo WOQ-9 foi congruente em 54,5% dos casos com a avaliação neurológica. Conclusão: O WOQ-9 é um método de rastreamento útil para identificar WO em pacientes com DP, e é um questionário de autoavaliação cuja aplicação é fácil e rápida.Palavras-chave: doença de Parkinson, levodopa, wearing-off, questionários.The treatment of Parkinson's disease (PD) remains a major challenge spite of the increasing therapeutic arsenal in recent decades and progressing knowledge of its pathophysiology. Levodopa (LD) remains the most effective and widely prescribed drug in the symptomatic treatment of PD 1 . Currently it is acknowledged that up to 50% of patients have motor fluctuations after two years of the introduction of LD or another dopaminergic agonist (DA) 2,3 . The long-term use of levodopa leads to complications directly related to the duration of the treatment. Such complications include motor symptoms (MS) and non-motor symptoms (NMS). The most frequent motor complications are the motor fluctuations and dyskinesias. Wearing-off (WO) is one subtype of motor fluctuation and occurs over time, when the effectiveness of a dose of dopaminergic agonist tends to wear off earlier than before. For confirmation of this phenomeno...

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Identification of wearing-off manifestations (reduction of levodopa effect) in Parkinson's disease using specific questionnaire and comparison of the results with routine ambulatory evaluations

Cited by 11 publications

References 10 publications

Wearing-off detection in clinical practice: The wearing off real practice key (WORK-PD) study in Parkinson's disease

Wearing-off detection in clinical practice: The wearing off real practice key (WORK-PD) study in Parkinson's disease

The Most Bothersome Aspects of Off Periods Reported by Individuals with Parkinson's Disease

Specificity and sensibility of 9-Itens Wearing-off Questionnaire in Brazilian Parkinson disease patient sample

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