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Nonmotor fluctuations in Parkinson disease: Severity and correlation with motor complications.

Storch, Alexander; Schneider, Christine B; Wolz, Martin; Stürwald, Yannic; Nebe, Angelika; Odin, Per LU ; Mahler, Andreas; Fuchs, Gerd; Jost, Wolfgang H and Chaudhuri, K Ray, et al. (2013) In Neurology 80(9). p.800-809
Abstract
OBJECTIVE: To evaluate frequency, severity, and correlation of nonmotor symptoms (NMS) with motor complications in fluctuating Parkinson disease (PD). METHODS: The Multicenter NonMotor Fluctuations in PD cross-sectional study used clinical examination of 10 NMS (dysphagia, anxiety, depression, fatigue, excessive sweating, inner restlessness, pain, concentration/attention, dizziness, bladder urgency) quantified using a visual analogue scale (VAS) in motor-defined on (NMS(On)) and off state (NMS(Off)) combined with motor assessments and self-ratings at home in 100 patients with advanced PD. RESULTS: All NMS except dysphagia, excessive sweating, and bladder urgency fluctuated in conjunction to motor fluctuations with more frequent and severe... (More)
OBJECTIVE: To evaluate frequency, severity, and correlation of nonmotor symptoms (NMS) with motor complications in fluctuating Parkinson disease (PD). METHODS: The Multicenter NonMotor Fluctuations in PD cross-sectional study used clinical examination of 10 NMS (dysphagia, anxiety, depression, fatigue, excessive sweating, inner restlessness, pain, concentration/attention, dizziness, bladder urgency) quantified using a visual analogue scale (VAS) in motor-defined on (NMS(On)) and off state (NMS(Off)) combined with motor assessments and self-ratings at home in 100 patients with advanced PD. RESULTS: All NMS except dysphagia, excessive sweating, and bladder urgency fluctuated in conjunction to motor fluctuations with more frequent and severe symptoms in off compared to on state. The proportions of patients experiencing autonomic/sensory NMS in both motor states were similar to those with these NMS exclusively in off state (ratios 0.4-1.3), while for mental/psychic NMS the proportions with exclusive manifestation in off state were higher (ratios 1.8-3.1). Demographic and clinical characteristics correlated neither with NMS frequency patterns and severities nor with ΔNMS(On/Off) severities (defined as the differences of VAS scores between on and off). Severities of NMS(on), NMS(Off), and ΔNMS(On/Off) did not correlate with motor function. Presence of anxiety, depression, fatigue, and pain had negative impact on health-related quality of life (HRQOL) measured by Parkinson's Disease Questionnaire-8 scoring independent of their occurrence with respect to motor state. Fluctuations of these NMS but not of fatigue deteriorated HRQOL. CONCLUSION: Patterns of NMS fluctuations are heterogeneous and complex, but psychic NMS fluctuate more frequently and severely. Demographic parameters and motor function do not correlate with NMS or nonmotor fluctuation severities in fluctuating PD. (Less)
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Contribution to journal
publication status
published
subject
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Neurology
volume
80
issue
9
pages
800 - 809
publisher
American Academy of Neurology
external identifiers
  • wos:000315451200013
  • pmid:23365054
  • scopus:84876328040
ISSN
1526-632X
DOI
10.1212/WNL.0b013e318285c0ed
language
English
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yes
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1dd32421-b79b-4aa0-bfc1-46baff0fa796 (old id 3560409)
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http://www.ncbi.nlm.nih.gov/pubmed/23365054?dopt=Abstract
date added to LUP
2013-03-01 11:42:34
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2019-08-25 03:26:10
@article{1dd32421-b79b-4aa0-bfc1-46baff0fa796,
  abstract     = {OBJECTIVE: To evaluate frequency, severity, and correlation of nonmotor symptoms (NMS) with motor complications in fluctuating Parkinson disease (PD). METHODS: The Multicenter NonMotor Fluctuations in PD cross-sectional study used clinical examination of 10 NMS (dysphagia, anxiety, depression, fatigue, excessive sweating, inner restlessness, pain, concentration/attention, dizziness, bladder urgency) quantified using a visual analogue scale (VAS) in motor-defined on (NMS(On)) and off state (NMS(Off)) combined with motor assessments and self-ratings at home in 100 patients with advanced PD. RESULTS: All NMS except dysphagia, excessive sweating, and bladder urgency fluctuated in conjunction to motor fluctuations with more frequent and severe symptoms in off compared to on state. The proportions of patients experiencing autonomic/sensory NMS in both motor states were similar to those with these NMS exclusively in off state (ratios 0.4-1.3), while for mental/psychic NMS the proportions with exclusive manifestation in off state were higher (ratios 1.8-3.1). Demographic and clinical characteristics correlated neither with NMS frequency patterns and severities nor with ΔNMS(On/Off) severities (defined as the differences of VAS scores between on and off). Severities of NMS(on), NMS(Off), and ΔNMS(On/Off) did not correlate with motor function. Presence of anxiety, depression, fatigue, and pain had negative impact on health-related quality of life (HRQOL) measured by Parkinson's Disease Questionnaire-8 scoring independent of their occurrence with respect to motor state. Fluctuations of these NMS but not of fatigue deteriorated HRQOL. CONCLUSION: Patterns of NMS fluctuations are heterogeneous and complex, but psychic NMS fluctuate more frequently and severely. Demographic parameters and motor function do not correlate with NMS or nonmotor fluctuation severities in fluctuating PD.},
  author       = {Storch, Alexander and Schneider, Christine B and Wolz, Martin and Stürwald, Yannic and Nebe, Angelika and Odin, Per and Mahler, Andreas and Fuchs, Gerd and Jost, Wolfgang H and Chaudhuri, K Ray and Koch, Rainer and Reichmann, Heinz and Ebersbach, Georg},
  issn         = {1526-632X},
  language     = {eng},
  number       = {9},
  pages        = {800--809},
  publisher    = {American Academy of Neurology},
  series       = {Neurology},
  title        = {Nonmotor fluctuations in Parkinson disease: Severity and correlation with motor complications.},
  url          = {http://dx.doi.org/10.1212/WNL.0b013e318285c0ed},
  volume       = {80},
  year         = {2013},
}