Objective: To characterise the pattern of daily motor fluctuations in Korean patients with Parkinson’s disease (PD) and early motor fluctuations.

Background: Patients with PD may be at their optimal clinical state when attending medical appointments. It is therefore important for clinicians to be familiar with the typical pattern of motor fluctuations that patients may experience. Even when patients appear to be doing well during evaluations, obtaining an accurate history regarding potential fluctuations is essential.

Method: Home diaries from patients with PD and early motor fluctuations included in the Korean ADOPTION study were analysed. Patients’ 24-hour diary data were evaluated per daily hour. Asleep and ON/OFF fluctuations were characterised and depicted by daily hour. ON/OFF fluctuations were also characterised by daily available hour (i.e., corrected for daily-hour asleep).

Results: All 169 randomised patients were included in the analysis. The majority of asleep-time (defined as being asleep for more than 50% per hour) occurred within 10 pm to 6 am [Figure 1A]. During the waking hours (6 am–10 pm), three distinct OFF/ON transition periods (during which minimum duration in ON-time and maximum duration in OFF-time matched) were observed [Figures 1A and 1B] – a pattern consistent with the majority of patients following a thrice-daily L-DOPA regimen. Upon correcting for asleep-time, mean OFF-time accounted for approximately 23% per available daily hour; ON-time ranged between 42–92% per available daily hour; the maximum duration of ON-time per daily hour was similar across the transition periods with an apparent shorter duration during the evening [Figures 1A and 1B].

Conclusion: In the Korean ADOPTION study, patients with PD and early motor fluctuations experienced an approximate 23% prevalence of OFF-time per daily hour despite optimal anti-PD therapy. Understanding the population pattern of daily motor fluctuations may help clinicians conduct an adequate clinical evaluation and optimise treatment strategies.

Figure 1

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MDS Abstracts - https://www.mdsabstracts.org/abstract/characterisation-of-the-pattern-of-daily-motor-fluctuations-in-patients-with-parkinsons-disease-and-early-motor-fluctuations-findings-from-the-korean-adoption-study/