Objective: To determine (1) the diagnostic properties of WOQ-19 for the diagnosis of wearing off in Mexican patients with PD; (2) the best cut-off value of WOQ-19 for the diagnosis of wearing-off; (3) and the frequency of the symptoms related to wearing off as assessed by WOQ-19.

Background: Motor complications frequently develop within 2 years of dopaminergic therapy in patients with PD. Of these, the most frequently reported is “wearing off”, where patients find that therapeutic effect of each dose decreases and is no longer maintained through the end of the dosing interval. The WOQ-19, a shorter version derived from the WOQ-32, is used to assess the presence of wearing off. Although this instrument has been previously validated, results have varied among populations, suggesting that transcultural validation is necessary.

Methods: A cross-sectional study was carried out. Consecutive Mexican subjects with PD were included. All patients were evaluated by a neurologist with expertise in movement disorders and clinical criterion was considered “gold-standard” for the diagnosis of wearing off. Patients independently completed the Spanish version of WOQ-19.

Results: 174 patients were included, of which 67.2% had wearing off according to clinical criterion. Patients with wearing off had longer disease duration, a more severe disease, higher levodopa equivalent daily dose, and experienced dyskinesia with higher frequency. A cut-off value of 4 in the WOQ-19 showed the following diagnostic attributes: sensibility, 64.9%; specificity, 73.5%; positive and negative predictive value, 54.3% and 81.1% respectively. The area under the ROC curve was 0.76 (95% CI 0.69-0.82). Tremor was the most frequent symptom (39.1%) reported to improve after levodopa dosage in patients without wearing off; whereas slowness of movement (84.1%), rigidity (79.3%), tremor (74.4%), reduced dexterity (73.2%) and problems with balance (64.6%) were the most prevalent symptoms to benefit from levodopa dosage in patients with wearing off.

Conclusions: The Spanish version of the WOQ-19 may be a useful instrument for the screening of wearing off in Mexican patients with PD. Our findings suggest that the presence of at least four symptoms provided the best performance for the WOQ-19 in our sample.

Partial results presented in the XXXIX Anual Meeting of the Mexican Academy of Neurology.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/diagnostic-performance-of-the-spanish-version-of-the-19-items-wearing-off-questionnaire-in-mexican-patients-with-pd/