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Quantitative assessment of non-motor fluctuations in Parkinson's disease using the Non-Motor Symptoms Scale (NMSS)

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Alexander Storch, Christine B. Schneider, Lisa Klingelhoefer, Per Odin, Gerd Fuchs, Wolfgang H. Jost, Pablo Martinez-Martin, Rainer Koch, Heinz Reichmann, K. Ray Chaudhuri, Georg Ebersbach, NoMoFIu-PD Study Grp

Original languageEnglish
Pages (from-to)1673-1684
Number of pages12
JournalJournal of Neural Transmission
Issue number12
Early online date12 Aug 2015
Publication statusPublished - Dec 2015

King's Authors


Data on frequency, severity and correlations of NMS with motor complications are only available for a limited number of NMS. The NMS Scale (NMSS) is a validated tool to assess a broad range of NMS, which has not been used in NMS fluctuations. We assessed fluctuations of a broad range of non-motor symptom (NMS) for a 1-month time period in fluctuating Parkinson's disease (PD) in a multicenter cross-sectional study using the NMSS assessing NMS in motor On (NMSSOn) and Off state (NMSSOff) combined with clinical NMS and motor function scoring in 100 fluctuating PD patients. Delta NMSSOn/Off was defined as the differences of NMSS scores between On and Off. Complete NMSS datasets were available from 73 patients (53 % men; age: 68.2 +/- A 9.7 years) with mean total NMSS score in On state of 41.5 +/- A 37.6 and in Off state of 75.6 +/- A 42.3 (P <0.001). Scores were higher in Off compared to On state for all domains except for domain "perceptual problems/hallucinations" (P = 0.608). Clinimetric properties of the NMSS were similar to those reported previously for NMS assessments independent of motor oscillations. NMSSOn, NMSSOff and Delta NMSSOn/Off showed weak to moderate correlations with demographics, indicators of motor symptom severity as well as with other measures of NMS, depression and quality of life. Correlations of NMSS items/domains with independent measures of related constructs were weak to moderate. In conclusion, when assessed with the NMSS, a broad range of NMS fluctuate with motor oscillations, but these fluctuations do neither correlate with motor function nor with measures of disease progression.

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