Article Text

Download PDFPDF
Original research
ON/OFF non-motor evaluation: a new way to evaluate non-motor fluctuations in Parkinson’s disease
  1. Florent Faggianelli1,
  2. Tatiana Witjas2,
  3. J-P Azulay3,
  4. Isabelle Benatru4,
  5. Cécile Hubsch5,
  6. Mathieu Anheim6,
  7. Caroline Moreau7,
  8. Elodie Hainque8,
  9. Sophie Drapier9,
  10. Béchir Jarraya10,
  11. Chloé Laurencin11,12,
  12. Dominique Guehl13,14,
  13. Lucie Hopes15,
  14. Christine Brefel-Courbon16,
  15. Melissa Tir17,
  16. Ana Marques18,19,
  17. Tiphaine Rouaud20,
  18. David Maltete21,
  19. Caroline Giordana15,
  20. Karine Baumstarck22,
  21. Olivier Rascol23,
  22. Jean Christophe Corvol24,
  23. Anne-Sophie Rolland25,
  24. David Devos26,
  25. Alexandre Eusebio27
  26. PREDISTIM study group
    1. 1Neurology, CHU Timone, Marseille, France
    2. 2Department of Neurology, University Hospital Timone, Marseille, France
    3. 3CHU Timone, Marseille, France
    4. 4Centre Hospitalier Universitaire de Poitiers, Poitiers, France
    5. 5Neurology, Fondation Ophtalmologique Adolphe de Rothschild, Paris, France
    6. 6Service de Neurologie, Hopital de Hautepierre, Strasbourg, France
    7. 7Neurology Expert Center for Parkinson's disease, University of Lille, Lille, France
    8. 8Département de Neurologie, APHP, Paris, France
    9. 9Neurologie, CHU Pontchaillou, Rennes, France
    10. 10Neuroscience, Hospital Foch, Suresnes, Île-de-France, France
    11. 11CNRS UMR 5229, Bron, France
    12. 12Centre Expert Parkinson, Bron, France
    13. 13Pôle de Neurosciences Cliniques, CHU de Bordeaux, Bordeaux, France
    14. 14CNRS UMR 5293, Institut des Maladies Neurodegeneratives, Bordeaux, France
    15. 15Neurology, Centre Hospitalier Universitaire de Nancy, Nancy, Lorraine, France
    16. 16Clinical Pharmacology and Neurosciences, University Hospital Centre Toulouse, Toulouse, Occitanie, France
    17. 17Neurology, CHU Amiens-Picardie, Amiens, Hauts-de-France, France
    18. 18EA7280, Université Clermont Auvergne, Clermont-Ferrand, France
    19. 19Neurology, University Hospital Centre Clermont-Ferrand, Clermont-Ferrand, France
    20. 20Department of Neurology, Nantes University Hospital, Nantes, France
    21. 21Neurology, Rouen University Hospital, Rouen, France
    22. 22Aix Marseille Université, EA 3279 Self-Perceived Health Assessment Research Unit, Marseille, France
    23. 23Pharmacology, Toulouse University, Toulouse, France
    24. 24Department of Neurology, Hopital Pitie-Salpetriere, Paris, France
    25. 25Department of Medical Pharmacology, Neurology and Movement Disorders Department, Referent Center of Parkinson’s Disease, CHU of Lille, Univ. Lille Neuroscience & Cognition, Inserm, UMR-S1172, Lille, France
    26. 26Medical Pharmacology, Lille University Medical Center, Lille, France
    27. 27APHM, Marseille, France
    1. Correspondence to Dr Florent Faggianelli, Neurolgy, CHU Timone, Marseille 13385, France; Florent.faggianelli{at}gmail.com

    Abstract

    Background NMF 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).

    Methods Patients 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.

    Results 310 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.

    Conclusions This 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.

    • PARKINSON'S DISEASE
    • MOVEMENT DISORDERS
    • SCALES

    Data availability statement

    No data are available.

    Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    Data availability statement

    No data are available.

    View Full Text

    Footnotes

    • Collaborators Luc Defebvre, Nicolas Carriere, Guillaume Grolez, Gillaume Baille, Kreisler, Jean-Pierre Pruvo, Pr Leclerc, Renaud Lopes, Romain Viard, Gregory Kuchcinski, Julien Dumont, Kathy Dujardin, M Delliaux, M Brion, Gustavo Touzet, Nicolas Reyns, Arnaud Delval, Valerie Santraine, Marie Pleuvret, Nolwen Dautrevaux, Victor Laugeais, Morgane Coeffet, Thavarak Ouk, Camille Potey, Celine Leclercq, Elise Gers, Jean-Christophe Corvol, Marie Vidailhet, Marie-Laure Welter, Lucette Lacomblez, David Grabli, Emmanuel Roze, Yulia Worbe, Cécile Delorme, Hana You, Jonas Ihle, Raquel Guimeraes-Costa, Florence Cormier-Dequaire, Aurélie Méneret, Andréas Hartmann, Louise-Laure Mariani, Stéphane Lehericy, Virginie Czernecki, Fanny Pineau, Frédérique Bozon, Camille Huiban, Eve Benchetrit, Carine Karachi, Soledad Navarro, Philippe Cornu, Arlette Welaratne, Carole Dongmo-Kenfack, Lise Mantisi, Nathalie Jarry, Sophie Aix, Carine Lefort, Philippe Damier, Pascal Derkinderen, Anne-Gaelle Corbille, Elisabeth Calvier-Auffray, Madame Laetitia Rocher, Madame Anne-Laure Deruet, Raoul Sylvie, Roualdes Vincent, Le Dily Séverine, Berangere Debilly, Franck Durif, Philippe Derost, Charlotte Beal, Carine Chassain, Laure Delaby, Tiphaine Vidal, Jean Jeacques Lemaire, Isabelle Rieu, Elodie Durand, Frédérique Fluchère, Stephan Grimaldi, Nadine Girard, Eve Benchetrit, Marie Delfini, Romain Carron, Jean Regis, Giorgio Spatola, Camille Magnaudet, Ansquer Solène, Colin Olivier, Houeto J L, Guillevin Remy, Fradet Anne, Anziza Manssouri, Blondeau Sophie, Richard Philippe, Cam Philippe, Page Philippe, Bataille Benoit, Rabois Emilie, Guillemain Annie, Frédérique Leh, Alexandre Bonnet, Marc Vérin, Jean-Christophe Ferré, Jean François Houvenaghel, Claire Haegelen, Francoise Kestens, Solenn Ory, Pierre Burbaud, Nathalie Damon-Perriere, Wassilios Meissner, Francois Tison, Stéphanie Bannier, Elsa Krim, Sandrine Molinier-Blossier, Morgan Ollivier, Marion Lacoste, Nicolas Auzou, Marie Bonnet, Emmanuel Cuny, Julien Engelhardt, Olivier Branchard, Clotilde Huet, Julie Blanchard, Fabienne Ory Magne, Marion Simonetta Moreau, Christophe Arbus, Fabrice Bonnevilleet, Jean Albert Lotterie, Marion Sarrail, Patrick Chaynes, François Caire, Estelle Harroch, Romain Lefaucheur, Damien Fetter, Nicolas Magne, Sandrine Bioux, Maud Loubeyre, Evangéline Bliaux, Dorothée Pouliquen, Stéphane Derrey, Linda Vernon, Frédéric Ziegler, Ouhaid Lagha-Boukbiza, Christine Tranchant, Odile Gebus, Solveig Montaut, Stéphane Kremer, Nadine Longato, Clélie Phillips, Jimmy Voirin, Marie desNeiges Santin, Dominique Chaussemy, Amaury Mengin, Claire Marsé, Lydiane Mondot, Bruno Giordana, Robin Kardous, Bernadette Bailet, Héloise Joly, Denys Fontaine, Aurélie Leplus, Amélie Faustini, Vanessa Ferrier, Pierre Krystkowiak, Jean-Marc Constans, Sandrine Wannepain, Audrey Seling, Michel Lefranc, Stéphanie Blin, Béatrice Schuler, Stephane Thobois, Teodor Danaila, Yves Berthezene, Roxana Ameli, Helene Klinger, Gustavo Polo, Patrick Mertens, A Nunes, Elise Metereau, Solène Frismand, Emmanuelle Schmitt, Mylène Meyer, Céline Dillier, Sophie Colnat, Anne Chatelain, Jean- Philippe Brandel, Patte Karsenti, Marie Lebouteux, Marc Ziegler, Christine Delmaire, Julien Savatowky, Juliette Vrillac, Claire Nakache, Vincent D’Hardemare, Lhaouas Belamri, Valérie Mesnage, Cécilia Bonnet, Jarbas Correa, Lino Junior, Camille Decrocq, Anne Boulin, Stéphanie Auliac-Condette, Julie Gratieux, Dilanda Terfaia, Bérénice Gardel, Delphine Lopez, Lydie Prette, Fantoumata Sacko, Catherine Ziz, David Gay, Robin Bonicel, Fouzia El Mountassir, Clara Fischer, Jean-François Mangin, Marie Chupin, Yann Cointepas, Bertrand Accart, Patrick Gelé, Florine Fievet, Matthieu Chabel, Virginie Derenaucourt, Loïc Facon, Yanick Tchantchou Njosse, Dominique Deplanque, Alain Duhamel, Lynda Djemmane, Florence Duflot, Hajar Chouiki

    • Funding This study was funded by Ministère de la Santé; Association France Parkinson.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.