Objective: The aim of this study was to explore the relation between non-motor neuropsychological fluctuations, identified with the Neuropsychiatric Fluctuation Scale (NFS), and motor fluctuations and dyskinesia, investigated with the Parkinson’s Kinetigraph (Global Kinetics Corporation: PKG) in Parkinson’s Disease (PD) patients.

Background: Non-motor fluctuations, including neuropsychiatric fluctuations, are frequent in PD patients with motor complication and can be more troublesome and disabling than motor disturbances. The temporal correlation between motor and non-motor fluctuation is not yet completely clarified.

Method: Non-demented PD patients with motor and non-motor fluctuations were recruited. They were assessed using: 1) the NFS (20 items self-administered questionnaire, 10 items for the ON- and 10 for the OFF neuropsychiatric states), to identify and quantify neuropsychiatric fluctuation in acute settings; 2) the PKG system, a watch-like device, able to detect motor fluctuations and dyskinesia. All patients worn for 6 consecutive days the PKG to obtain a 6-day preliminary recording to identify ON and OFF motor periods. Afterwards, each patient received the PKG for the second time and was taught to fill in the NFS 3 times/day during the previously identified ON and OFF periods. Bradykinesia score (BKS) and dyskinesia score (DKS) were obtained by a specific algorithm that elaborated PKG data detected during the 3-day recording. Data of BKS and DKS were collected and analyzed at the time when patients filled the NFS.

Results: In 18 patients, we find a positive correlation between the BKS and NFS OFF subscores (p=0.036, r=0.51), whereas no correlation was found between DKS and the NFS ON subscores (p=0.38, r=0.22). Interestingly, NFS ON/OFF subscores inversely correlates with each other (p=0.002, r=-0.69) as BKS and DKS (p=0.042, r=-0.49). We also found a positive correlation between age and the NFS OFF subscores (p=0.023, r=0.56), and a negative correlation with the NFS ON subscores (p=0.024, r=-0.55).

Conclusion: Our findings show that the non-motor OFF conditions temporarily match the OFF motor fluctuations, whereas non-motor ON conditions may not match the ON motor state in PD fluctuating patients. Moreover, the NFS can be a useful tool to investigate non-motor fluctuations in patient with motor complications.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/do-non-motor-fluctuations-temporarily-match-on-off-motor-condition/