• Florent Faggianelli, Tatiana Witjas, J-P Azulay, Isabelle Benatru, Cécile Hubsch, Mathieu Anheim, Caroline Moreau, Elodie Hainque, Sophie Drapier, Béchir Jarraya, Chloé Laurencin, Dominique Guehl, Lucie Hopes, Christine Brefel-Courbon, Melissa Tir, Ana Marques, Tiphaine Rouaud, David Maltete, Caroline Giordana, Karine Baumstarck, Olivier Rascol, Jean Christophe Corvol, Anne-Sophie Rolland, David Devos, Alexandre Eusebio, and PREDISTIM study group.
• Neurology, CHU Timone, Marseille, France Florent.faggianelli@gmail.com.
• J. Neurol. Neurosurg. Psychiatr. 2024 Jun 17; 95 (7): 656662656-662.

BackgroundNMF are currently poorly evaluated in therapeutic decisions. A quantification of their severity would facilitate their integration. The objective of this study was to validate an autoquestionnaire evaluating the severity of non-motor fluctuations (NMF) in Parkinson's disease (PD).MethodsPatients with PD were included in presurgical situation for deep brain stimulation of subthalamic nuclei. They participated in the PREDISTIM cohort (a study evaluating the predictive factors for therapeutic response of subthalamic stimulation in PD) in 17 centres in France. Our questionnaire, resulting from previous phases of development, included 11 non-motor symptoms (NMS). Their severity ranged from 0 to 10 and was assessed in OFF and then ON-Dopa to study their fluctuations.Results310 patients were included, of whom 98.8% had NMS and 98.0% had NMF. Each NMS was significantly improved by L-Dopa (decrease in severity score ranging from 43.1% to 69.9%). Fatigue was the most frequent and most severe NMS. NMS were considered more bothersome than motor symptoms by 37.5% of patients in OFF-Dopa and 34.9% in ON-Dopa.ConclusionsThis is the first questionnaire allowing a real-time quantification of the severity of NMS and their fluctuation with levodopa. It was able to confirm and measure the effect of L-dopa and show differences according to the patients and the NMS. It differs from other questionnaires by its measurement at a precise moment of the severity of the NMS, allowing its use during pretherapeutic assessments.Our questionnaire has been validated to measure the severity of NMF. It will be able to quantify the non-motor effect of anti-parkinsonian treatments and could facilitate the integration of NMF in therapeutic decisions.© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.

21 keywords...

hide…