Session Time: 1:15pm-2:45pm
Location: Agora 3 West, Level 3
Objective: We aimed: 1) To evaluate the relationship between motor (MF) and non-motor (NMF) fluctuations in Parkinson’s disease measured with patient’s self-assessment, clinician’s evaluationand objective measurement using a wearable device. 2) To explore the relationship between MF, NMF and quality of life.
Background: MF and NMF fluctuations are difficult to recognize and might have a severe impact on quality of life.
Method: We enrolled consecutive PD patients who presented at least motor fluctuations. Levodopa equivalent daily dose (LEDD) and LEDD dopamine-agonist (D-Ag LEDD) were calculated. MF and NMF were assessed by the Wearing-Off Questionnaire (WOQ-19) and the Unified PD Rating Scale (UPDRS I-IV). The Parkinson’s KinetiGraph™ (PKG®), an accelerometry-based system for automated assessment of dyskinesia and bradykinesia was employed. The 39-item PD Questionnaire (PDQ-39) was administered.
Results: Fifty-six patients were included (37 males, age 60.4±6.5, disease duration 10.5±4.9), 100% self-reported MF, 83% had NMF as per WOQ-19. WOQ-19 motor and non-motor sub-scores were significantly associated (b-coef=0.4, 95%CI (0.2,0.6), p<0.0001). Multivariable regression analyses showed that D-Ag LEDD, UPDRS-III-OFF, UPDRS-IV and ‘percent time with fluctuations’ as per PKG were significantly associated with WOQ-19 motor sub-score. WOQ-19 non-motor sub-score was associated to UPDRS-III-OFF. When classifying our patients according to ‘percent time with fluctuation’ PKG outcome, 50% had no MF, 25% had mild/moderate and 25% had severe MF. Patients without fluctuations had lower D-Ag LEDD, lower score at RDRS and WOQ-motor sub-scale (p<0.05). According to ‘percent time with dyskinesia’ PKG outcome, 55% of patients had no dyskinesia, 23% had mild and 22% had severe dyskinesia. Patients with no dyskinesia had lower D-Ag LEDD and RDRS score (p<0.05). Only WOQ-19 psychiatric fluctuation was significantly associated to PDQ-39.
Conclusion: Our findings suggest that MF and NMF are related to each other but independently associated to specific clinical variables. NMF and specifically, psychiatric fluctuations, impact patient’s quality of life.
To cite this abstract in AMA style:A. Leake, A. de Angelis, M. Horne, D. Paviour, J. Coebergh, M. Edwards, F. Morgante, L. Ricciardi. Exploring the relationship between motor and non-motor fluctuations in Parkinson’s disease: patient’s perspective, clinician’ s assessment and objective measures from a wearable device [abstract]. Mov Disord. 2019; 34 (suppl 2). https://www.mdsabstracts.org/abstract/exploring-the-relationship-between-motor-and-non-motor-fluctuations-in-parkinsons-disease-patients-perspective-clinician-s-assessment-and-objective-measures-from-a-wearabl/. Accessed December 2, 2023.
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MDS Abstracts - https://www.mdsabstracts.org/abstract/exploring-the-relationship-between-motor-and-non-motor-fluctuations-in-parkinsons-disease-patients-perspective-clinician-s-assessment-and-objective-measures-from-a-wearabl/