Assessment of Nonmotor Fluctuations Using a Diary in Advanced Parkinson’s disease

Ossig, Christiana; Sippel, D.; Fauser, Mareike; Gandor, Florin; Jost, Wolfgang H.; Ebersbach, Georg; Storch, Alexander

doi:10.3233/jpd-150764

Cited by 20 publications

(17 citation statements)

References 25 publications

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“…45 Changes in NMS are not always time-locked to those of motor manifestations, 8,20,39,54,55 and fluctuations in NMS do not always correlate with motor function. 42,54,56 This finding suggests the possible existence of different pathophysiological mechanisms in the genesis of MF and NMF. However, a relationship appears between dopaminergic therapy intake and improvement in fluctuating NMS, such as apathy or pain.…”

Section: Clinical Presentation and Epidemiology Of Nmfmentioning

confidence: 78%

“…Changes in NMS are not always time‐locked to those of motor manifestations, and fluctuations in NMS do not always correlate with motor function . This finding suggests the possible existence of different pathophysiological mechanisms in the genesis of MF and NMF.…”

Section: Pathophysiology Of Nmfmentioning

confidence: 93%

“…151 In order to investigate the prevalence and severity of NMF, a few studies have assessed the presence of NMS during motor fluctuations using open questionnaires, 21,38,39,41 the self-completed Non-Motor Symptoms Questionnaire for PD (NMSQuest), 23,152 the WOQ-19, 32,40 the WOQ-9, 23 and, more recently, the Non-Motor Symptoms Scale (NMSS). 42,56 The Ardouin Scale for Behavioral Assessment in Parkinson's Disease evaluates hypo-and hyperdopaminergic behaviors and allows to detect and quantify neuropsychiatric fluctuations by evaluating OFF-drug dysphoria and ON-drug euphoria. 144,153 It has been shown that self-administered questionnaires (providing the patient the vocabulary required) are more sensitive than semistructured interviews (dependent on insight by the patient and interpretation of symptoms by the evaluator) in the detection of both motor and NMF.…”

Section: Management Of Nmf Current Evaluation Toolsmentioning

confidence: 99%

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The hidden sister of motor fluctuations in Parkinson's disease: A review on nonmotor fluctuations

et al. 2016

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Only a few years after the introduction of levodopa, the first descriptions of motor fluctuations and dyskinesia related to dopaminergic therapy appeared. In PD, attention turned to their management, that had dampened the euphoria of the “levodopa miracle.” It soon became clear that neuropsychiatric, autonomic, and sensory features also tend to develop fluctuations after chronic exposure to l‐dopa. The diversity of fluctuating nonmotor symptoms, their largely subjective nature, coupled with a frequent lack of insight led to difficulties in identification and quantification. This may explain why, despite the high impact of nonmotor symptoms on patient autonomy and quality of life, evaluation of nonmotor fluctuations is not part of clinical routine. In view of the lack of specific validated assessment tools, detailed anamnesis should ideally be coupled with an evaluation in both ON and OFF drug conditions. The mechanisms of nonmotor fluctuations are not well understood. It is thought that they share dopaminergic presynaptic pharmacokinetic and postsynaptic pharmacodynamic mechanisms with the classical motor complications, but involve different neural pathways. Although symptoms fluctuate with dopaminergic treatment, serotonine and norepinephrine denervation, as well as interactions between neurotransmitter systems, probably contribute to their diversity. The lack of validated tools for assessment of these phenomena explains the almost complete absence of treatment studies. Management, largely resulting from expert opinion, includes psychiatric follow‐up, nondopaminergic drugs, and advanced dopaminergic treatment, including drug delivery pumps and DBS. This review aims to provide a starting point for the understanding, diagnosis, and management of nonmotor fluctuations. © 2016 International Parkinson and Movement Disorder Society

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Section: Clinical Presentation and Epidemiology Of Nmfmentioning

confidence: 78%

Section: Pathophysiology Of Nmfmentioning

confidence: 93%

Section: Management Of Nmf Current Evaluation Toolsmentioning

confidence: 99%

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The hidden sister of motor fluctuations in Parkinson's disease: A review on nonmotor fluctuations

et al. 2016

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“…Two diaries (Parkinson Disease Home Diary and CAPSIT‐PD Diary) have been designated as “recommended” by the MDS Task Force on Rating Scales. Nonetheless, these 2 diaries have the caveat that limited data exist regarding their validity, compliance, and completion, and their assessment is implicitly linked to the presence of motor fluctuations . A systematic literature search found a total of 12 published PD diaries, for which a narrative review (Supplementary material 1) and quality criteria (Supplementary material 2) are available online.…”

Section: Current Gaps In Pd Diaries and Strategies To Address Them Inmentioning

confidence: 99%

“…One hope is that in the future, passive tracking should capture a subset of relevant MFs and NMFs . Smartphones, increasingly being used across all age groups, are ideally suited for the e‐Diary development, allowing for an ever‐present yet unobtrusive and ecologically valid data collection . Challenges related to the technological development include the costs associated with software and hardware development and maintenance, patient/health provider interface configuration, and regulatory difficulties with data storage, confidentiality, and management.…”

Section: Current Gaps In Pd Diaries and Strategies To Address Them Inmentioning

confidence: 99%

The Parkinson's disease e‐diary: Developing a clinical and research tool for the digital age

et al. 2019

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Associations Between Fluctuations in Daytime Sleepiness and Motor and Non‐Motor Symptoms in Parkinson's Disease

Höglund

Hagell

Broman

et al. 2020

Movement Disord Clin Pract

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Background Background: Non-motor fluctuations are a major concern in Parkinson's disease (PD), and they have been categorized into neuropsychiatric, autonomic and sensory fluctuations. However, this categorization does not include sleep and sleep-related features, and the association between daytime sleepiness and other motor and/or non-motor fluctuations in PD remains to be elucidated. Objective Objective: To investigate the relationship between daytime sleepiness and other non-motor and motor fluctuations in people with PD. Methods Methods: A three-day home diary recording daytime sleepiness, mood, anxiety, and motor symptoms was used along with the Karolinska Sleepiness Scale (KSS) and 6 days of accelerometer (Parkinson's KinetiGraph™; PKG™) registration to detect motor fluctuations among people with a DaTSCAN verified clinical PD diagnosis (32 men; mean PD duration, 8.2 years). Participants were categorized as motor fluctuators or non-fluctuators according to the UPDRS part IV and/or the presence of motor and non-motor fluctuations. Results Results: Fifty-two people with PD participated. Daytime sleepiness correlated significantly with motor symptoms, mood and anxiety among those classified as motor fluctuators (n = 28). Motor fluctuators showed stronger correlations between the individual mean level of all diary variables (daytime sleepiness, anxiety, mood and motor symptoms) when compared to the non-fluctuators (n = 24). Stronger positive within-individual correlations were found among fluctuators in comparison to non-fluctuators. In general, PKG data did not correlate with diary data. Conclusion Conclusion: Episodes of daytime sleepiness, as reported by home diaries, were associated with other selfreported non-motor and motor fluctuations, but were not supported by PKG data.

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Assessment of Nonmotor Fluctuations Using a Diary in Advanced Parkinson’s disease

Cited by 20 publications

References 25 publications

The hidden sister of motor fluctuations in Parkinson's disease: A review on nonmotor fluctuations

The hidden sister of motor fluctuations in Parkinson's disease: A review on nonmotor fluctuations

The Parkinson's disease e‐diary: Developing a clinical and research tool for the digital age

Associations Between Fluctuations in Daytime Sleepiness and Motor and Non‐Motor Symptoms in Parkinson's Disease

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