Objective: Home diary-based representation of patients’ daily motor status.

Background:
Parkinson’s disease (PD) patients are often in their best clinical state when attending medical appointments. It is therefore important for clinicians to be familiar with the typical pattern of motor fluctuations that patients experience and to obtain a good history regarding potential fluctuations even when patients are doing well at the time of the evaluation.

Method: Home diaries from patients from the BIPARK-I trial [1] with wearing-OFF, despite optimal anti-PD therapy, were used for analyses. Patients’ 24-h baseline diary data were evaluated per daily hour. Asleep and ON/OFF fluctuations were characterized and depicted by daily hour. ON/OFF fluctuations were also characterized by daily available hour (i.e., corrected for daily-hour asleep).

Results: A total of 354 patients were included in the analysis. The majority of asleep-time (>50%/h) was within 11pm to 6am (Figure 1A). During waking hours (7am–10pm), 4 OFF/ON transition periods were apparent, in line with a higher proportion of patients taking levodopa at 7–8am, 11–12am, ~4pm and 7–8pm (Figure 1B and 1C). Mean levodopa amount per daily hour intake was ~160mg. When asleep-time was negligible (<5%/h; 9am–9pm): mean OFF-time was ~35% per available daily hour; ON-time ranged from 57–76% per available daily hour; highest ON-time effect was at first ON-period with an apparent lower but stable effect over the remaining hours throughout the day (Figure 1B).

Conclusion: For patients enrolled in BIPARK-I, despite optimal anti-PD therapy, at baseline, the prevalence of OFF per daily hour was ~35%. Characterization of patients’ daily motor status is desirable for adequate clinical evaluation and for treatment optimization. Understanding the population pattern of daily motor fluctuations may help clinicians identify individual patient fluctuations.

References: 1. Ferreira JJ, et al. Lancet Neurol. 2016;15:154–65.

« Back to MDS Virtual Congress 2020

MDS Abstracts - https://www.mdsabstracts.org/abstract/characterization-of-the-pattern-of-daily-motor-fluctuations-in-parkinsons-disease-patients-based-on-home-diaries/