Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Apr 11;7(4):431-439.
doi: 10.1002/mdc3.12939. eCollection 2020 May.

Real-World Nonmotor Changes in Patients with Parkinson's Disease and Motor Fluctuations: J-FIRST

Hirohisa Watanabe  1 , Hidemoto Saiki  2 , Shih-Wei Chiu  3 , Takuhiro Yamaguchi  3 , Kenichi Kashihara  4 , Yoshio Tsuboi  5 , Masahiro Nomoto  6 , Nobutaka Hattori  7 , Tetsuya Maeda  8   9 , Yasushi Shimo  7 ; J‐FIRST Group
Affiliations

Real-World Nonmotor Changes in Patients with Parkinson's Disease and Motor Fluctuations: J-FIRST

Hirohisa Watanabe et al. Mov Disord Clin Pract. .

Abstract

Background: Nonmotor symptoms (NMSs) of Parkinson's disease (PD) impair health-related quality of life.

Objectives: To identify changes in NMSs during 52 weeks in Japanese PD patients exhibiting motor fluctuations.

Methods: In PD patients with ≥1 NMS and wearing-off, changes in total/subscore of the Movement Disorder Society Unified PD Rating Scale (MDS-UPDRS) Part I and 8-item PD Questionnaire were assessed. Group-based trajectory models were used to characterize longitudinal patterns of MDS-UPDRS Part I.

Results: Data from 996 patients were analyzed. MDS-UPDRS Part I subscores for cognitive function decreased linearly over time. Total and subscores for apathy and lightheadedness on standing significantly deteriorated with fluctuations, whereas other subscores fluctuated without significant deterioration. Changes in the MDS-UPDRS Part I total score correlated with changes in the 8-item PD Questionnaire total score. Based on group-based trajectory models, longitudinal pattern analysis of MDS-UPDRS Part I scores yielded the following 3 separate groups: unchanged (63.8%), deteriorated (20.1%), and improved (16.2%). The improved group had significantly more NMSs at baseline, significantly higher MDS-UPDRS Part I/8-item PD Questionnaire total scores, and modified Hoehn and Yahr scores, and had received treatment for NMSs. The multivariate analysis revealed significant associations between severe motor disability and receiving any treatment for NMSs at baseline and improvement of MDS-UPDRS Part I total scores.

Conclusions: Changes in MDS-UPDRS Part I scores were variable and related to changes in health-related quality of life in PD patients with motor fluctuations.

Keywords: Japan; Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS‐UPDRS); Parkinson's disease; nonmotor symptoms; observational study.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Overall MDS‐UPDRS Part I total score (A) and subscores for cognitive impairment (B), apathy (C), and lightheadedness on standing (D). MDS‐UPDRS, Movement Disorder Society Unified Parkinson's Disease Rating Scale; SE, standard error.
Figure 2
Figure 2
PDQ‐8 score (A) and correlation of MDS‐UPDRS Part I total score and PDQ‐8 score (B). MDS‐UPDRS, Movement Disorder Society Unified Parkinson's Disease Rating Scale; PDQ‐8, 8‐item Parkinson's Disease Questionnaire; SE, standard error.
Figure 3
Figure 3
Clustering based on changes in Movement Disorder Society Unified Parkinson's Disease Rating Scale total score. F, female; M, male.
See this image and copyright information in PMC

References

    1. Schapira AHV, Chaudhuri KR, Jenner P. Non‐motor features of Parkinson disease. Nat Rev Neurosci 2017;18:435–450. - PubMed
    1. Poewe W, Seppi K, Tanner CM, et al. Parkinson disease. Nat Rev Dis Primers 2017;3:17013–17021. - PubMed
    1. Antonini A, Barone P, Marconi R, et al. The progression of non‐motor symptoms in Parkinson's disease and their contribution to motor disability and quality of life. J Neurol 2012;259:2621–2631. - PubMed
    1. Berg D, Postuma RB, Adler CH, et al. MDS research criteria for prodromal Parkinson's disease. Mov Disord 2015;30:1600–1611. - PubMed
    1. Marinus J, Zhu K, Marras C, Aarsland D, van Hilten J. Risk factors for non‐motor symptoms in Parkinson's disease. Lancet Neurol 2018;17:559–568. - PubMed