Prevalence of Non-Motor Symptoms and Non-Motor Fluctuations in Parkinson's Disease Using the MDS-NMS

Carmen Rodriguez-Blazquez, Anette Schrag, Alexandra Rizos, K. Ray Chaudhuri, Pablo Martinez-Martin*, Daniel Weintraub

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

30 Citations (Scopus)


Background: Non-motor symptoms (NMS) are frequent in Parkinson's disease (PD). Objectives: To estimate the prevalence of NMS and of non-motor fluctuations (NMF) using the Movement Disorders Society-Non-Motor Rating Scale (MDS-NMS) and other scales assessing NMS, and their relationship with sex and PD severity. Methods: Cross-sectional study with a sample of 402 PD patients. The Hoehn and Yahr staging system (HY), Clinical Impression of Severity Index for PD (CISI-PD), MDS-NMS (including NMF- subscale), Non-Motor Symptoms scale (NMSS), and MDS-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) were applied. A NMS was considered present when scored ≥1. Differences in scores by sex and HY, CISI-PD, and MDS-UPDRS severity levels were calculated using Fisher's exact and chi-squared tests. Results: Using the MDS-NMS, NMS were present in 99.7% of patients and the mean number of NMS was 16.13 (SD: 9.36). The most prevalent NMS was muscle, joint or back pain (67.4% of the sample) and the least prevalent was dopamine dysregulation syndrome (2.2%). Feeling sad or depressed was significantly more prevalent in women. Using the MDS-NMS revealed more NMS than the other scales assessing NMS. NMF were present in 41% of the sample, with fatigue being the most prevalent symptom (68.5% patients with NMF), and no differences by sex. Patients with greater PD severity had higher prevalence of NMS than patients with lower severity. Conclusions: Almost all patients with PD experience NMS, and many experience NMF. Prevalence rates for NMS using the MDS-NMS are higher than on other scales used and increase with higher disease severity.

Original languageEnglish
Pages (from-to)231-239
Number of pages9
JournalMovement Disorders Clinical Practice
Issue number2
Publication statusPublished - Feb 2021


  • non-motor symptoms, prevalence, disease severity, MDS-NMS, NMSS, MDS-UPDRS


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