Objective: To validate an auto-questionnaire allowing a real time evaluation of the severity of NMF in PD.

Background: Non-motor fluctuations (NMF) in Parkinson’s disease (PD) are currently poorly evaluated in therapeutic decisions. A quantification of the severity of NMFs would facilitate their integration.

Method: Patients with PD were included in a pre-surgical situation for deep brain stimulation (DBS) of the subthalamic nuclei (STN). They participated in the PREDISTIM cohort in 17 centers in France. Our questionnaire, resulting from previous phases of development, included 11 clinically relevant NMFs. Their severity ranged from 0 to 10 and was assessed in OFF and then ON-Dopa conditions. The efficacy of L-Dopa on NMF and factors associated with NMF were evaluated.

Results: 310 patients were included, of whom 98.8% had NMF. Each NMF was significantly improved by L-Dopa (decrease in severity score ranging from 43.1% to 69.9% depending on the NFM). Fatigue was the most frequent and most severe NMF. NMF were considered more bothersome than motor fluctuations by 37.5% of patients in OFF Dopa and 34.9% in ON Dopa.

Conclusion: This is the first questionnaire allowing a real-time quantification of the severity of NMF according to the therapeutic conditions. It was able to confirm and measure the effect of L-dopa and show differences according to the patients and the NMF. It differs from other questionnaires by its measurement at a precise moment of the severity of the NMF, allowing its use during pre-therapeutic assessments.

Our questionnaire has been validated to measure the severity of NMF. It will be able to quantify the non-motor effect of antiparkinsonian treatments, and could facilitate the integration of NMFs in therapeutic decisions.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/on-off-non-motor-evaluation-a-new-way-to-evaluate-non-motor-fluctuations-in-parkinsons-disease/