Abstract
Objective: This multicenter cross-sectional study aimed to investigate the clinical features and varieties of non-motor fluctuation in Parkinson's disease (PD). Methods: To identify motor and non-motor fluctuation, we employed the wearing-off questionnaire of 19 symptoms (WOQ-19) in 464 PD patients. We compared the frequency of levodopa-related fluctuation as identified by the WOQ-19 with recognition by neurologists. We compared patients with both motor and non-motor fluctuations with those who only had motor fluctuations. Non-motor fluctuations were separated into psychiatric, autonomic, and sensory categories for further analysis. Results: The patients' average age was 70.8 ± 8.4 years (mean ± SD) and disease duration was 6.6 ± 5.0 years. The frequency of motor fluctuations was 69% and for non-motor fluctuation 40%. Fifty-three percent of patients with motor fluctuations also had non-motor fluctuations, whereas 93% of patients with non-motor fluctuations also had motor fluctuations. The WOQ-19 showed a sensitivity of 82% but a specificity of only 40%. The patients with both non-motor and motor fluctuations exhibited more severe motor symptoms, more non-motor symptoms and higher levodopa daily doses (p < 0.05). Patients had significantly higher fluctuation rates if they had psychiatric (49%) and sensory (45%) symptoms than patients with autonomic symptoms (32%, p < 0.01). Forty-eight percent of patients with non-motor fluctuations exhibited more than one type of non-motor fluctuation. Conclusion: Forty percent of PD patients presented with non-motor fluctuations, and almost half of these exhibited more than one type. Appropriate recognition of levodopa-related fluctuations, both motor and non-motor, can lead to treatment modifications in PD patients.
| Original language | English |
|---|---|
| Pages (from-to) | 104-108 |
| Number of pages | 5 |
| Journal | Parkinsonism and Related Disorders |
| Volume | 19 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - 2013 Jan |
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Keywords
- Japanese patients
- Non-motor fluctuations
- Non-motor symptoms
- Parkinson's disease
- Wearing-off
ASJC Scopus subject areas
- Geriatrics and Gerontology
- Clinical Neurology
- Neurology
Cite this
Clinical features and varieties of non-motor fluctuations in Parkinson's disease : A Japanese multicenter study. / Seki, Morinobu; Takahashi, Kazushi; Uematsu, Daisuke; Mihara, Ban; Morita, Yoko; Isozumi, Kazuo; Ohta, Kouichi; Muramatsu, Kazuhiro; Shirai, Toshitaka; Nogawa, Shigeru; Gotoh, Jun; Yamaguchi, Keiji; Tomita, Yutaka; Yasutomi, Daisuke; Nihei, Yoshihiro; Iwasawa, Satoko; Suzuki, Norihiro.
In: Parkinsonism and Related Disorders, Vol. 19, No. 1, 01.2013, p. 104-108.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Clinical features and varieties of non-motor fluctuations in Parkinson's disease
T2 - A Japanese multicenter study
AU - Seki, Morinobu
AU - Takahashi, Kazushi
AU - Uematsu, Daisuke
AU - Mihara, Ban
AU - Morita, Yoko
AU - Isozumi, Kazuo
AU - Ohta, Kouichi
AU - Muramatsu, Kazuhiro
AU - Shirai, Toshitaka
AU - Nogawa, Shigeru
AU - Gotoh, Jun
AU - Yamaguchi, Keiji
AU - Tomita, Yutaka
AU - Yasutomi, Daisuke
AU - Nihei, Yoshihiro
AU - Iwasawa, Satoko
AU - Suzuki, Norihiro
PY - 2013/1
Y1 - 2013/1
N2 - Objective: This multicenter cross-sectional study aimed to investigate the clinical features and varieties of non-motor fluctuation in Parkinson's disease (PD). Methods: To identify motor and non-motor fluctuation, we employed the wearing-off questionnaire of 19 symptoms (WOQ-19) in 464 PD patients. We compared the frequency of levodopa-related fluctuation as identified by the WOQ-19 with recognition by neurologists. We compared patients with both motor and non-motor fluctuations with those who only had motor fluctuations. Non-motor fluctuations were separated into psychiatric, autonomic, and sensory categories for further analysis. Results: The patients' average age was 70.8 ± 8.4 years (mean ± SD) and disease duration was 6.6 ± 5.0 years. The frequency of motor fluctuations was 69% and for non-motor fluctuation 40%. Fifty-three percent of patients with motor fluctuations also had non-motor fluctuations, whereas 93% of patients with non-motor fluctuations also had motor fluctuations. The WOQ-19 showed a sensitivity of 82% but a specificity of only 40%. The patients with both non-motor and motor fluctuations exhibited more severe motor symptoms, more non-motor symptoms and higher levodopa daily doses (p < 0.05). Patients had significantly higher fluctuation rates if they had psychiatric (49%) and sensory (45%) symptoms than patients with autonomic symptoms (32%, p < 0.01). Forty-eight percent of patients with non-motor fluctuations exhibited more than one type of non-motor fluctuation. Conclusion: Forty percent of PD patients presented with non-motor fluctuations, and almost half of these exhibited more than one type. Appropriate recognition of levodopa-related fluctuations, both motor and non-motor, can lead to treatment modifications in PD patients.
AB - Objective: This multicenter cross-sectional study aimed to investigate the clinical features and varieties of non-motor fluctuation in Parkinson's disease (PD). Methods: To identify motor and non-motor fluctuation, we employed the wearing-off questionnaire of 19 symptoms (WOQ-19) in 464 PD patients. We compared the frequency of levodopa-related fluctuation as identified by the WOQ-19 with recognition by neurologists. We compared patients with both motor and non-motor fluctuations with those who only had motor fluctuations. Non-motor fluctuations were separated into psychiatric, autonomic, and sensory categories for further analysis. Results: The patients' average age was 70.8 ± 8.4 years (mean ± SD) and disease duration was 6.6 ± 5.0 years. The frequency of motor fluctuations was 69% and for non-motor fluctuation 40%. Fifty-three percent of patients with motor fluctuations also had non-motor fluctuations, whereas 93% of patients with non-motor fluctuations also had motor fluctuations. The WOQ-19 showed a sensitivity of 82% but a specificity of only 40%. The patients with both non-motor and motor fluctuations exhibited more severe motor symptoms, more non-motor symptoms and higher levodopa daily doses (p < 0.05). Patients had significantly higher fluctuation rates if they had psychiatric (49%) and sensory (45%) symptoms than patients with autonomic symptoms (32%, p < 0.01). Forty-eight percent of patients with non-motor fluctuations exhibited more than one type of non-motor fluctuation. Conclusion: Forty percent of PD patients presented with non-motor fluctuations, and almost half of these exhibited more than one type. Appropriate recognition of levodopa-related fluctuations, both motor and non-motor, can lead to treatment modifications in PD patients.
KW - Japanese patients
KW - Non-motor fluctuations
KW - Non-motor symptoms
KW - Parkinson's disease
KW - Wearing-off
UR - http://www.scopus.com/inward/record.url?scp=84871493153&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84871493153&partnerID=8YFLogxK
U2 - 10.1016/j.parkreldis.2012.08.004
DO - 10.1016/j.parkreldis.2012.08.004
M3 - Article
VL - 19
SP - 104
EP - 108
JO - Parkinsonism and Related Disorders
JF - Parkinsonism and Related Disorders
SN - 1353-8020
IS - 1
ER -