Research output: Contribution to journal › Article › peer-review
Daniel Johannes van Wamelen, Silvia Rota, Anette Schrag, Alexandra Rizos, Pablo Martinez-Martin, Daniel Weintraub, Kallol Ray Chaudhuri
Original language | English |
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Pages (from-to) | 932-940 |
Number of pages | 9 |
Journal | Movement Disorders Clinical Practice |
Volume | 9 |
Issue number | 7 |
Early online date | 5 Aug 2022 |
DOIs | |
Accepted/In press | 3 Jul 2022 |
E-pub ahead of print | 5 Aug 2022 |
Published | Oct 2022 |
Additional links |
Characterization of Non-Motor_VAN WAMELEN_Publishedonline5August2022_GOLD VoR CC BY
Characterization_of_Non_Motor_VAN_WAMELEN_Publishedonline5August2022_GOLD_VoR_CC_BY.pdf, 298 KB, application/pdf
Uploaded date:09 Sep 2022
Version:Final published version
Licence:CC BY
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.
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