Validation of a non-motor fluctuations questionnaire in Parkinson's disease - 09/05/22

Doi : 10.1016/j.neurol.2021.06.013

F. Faggianelli ^a,^⁎ , A. Loundou ^b , K. Baumstarck ^b , S. Nathalie ^a, P. Auquier ^b , A. Eusebio ^a , L. Defebvre ^c , C. Brefel-Courbon ^d , J.-L. Houeto ^e , D. Maltete ^f , C. Tranchant ^g , P. Derkinderen ^h , C. Geny ⁱ , P. Krystkowiak ^j , B. Jean-Philippe ^k , F. Macia ^l , F. Durif ^m , A. Poujois ⁿ , M. Borg ^o , J.-P. Azulay ^a , T. Witjas ^a
for the
NS-Park FCRIN Network
^a Service de Neurologie et Pathologies du Mouvement, CHU Timone, APHM, Marseille, France
^b Centre D’Etudes et de Recherches sur les Services de Santé et Qualité, Faculté de Médecine, Aix-Marseille Université, Marseille, France
^c Service de Neurologie A, CHRU de Lille, Hôpital Roger Salengro, Marseille, France
^d Unité Neurologie cognitive, épilepsie, sommeil et mouvements anormaux, Département de Neurologie, CHU de Toulouse - Hôpital Purpan, Marseille, France
^e Service de Neurologie, CHU de Poitiers, Marseille, France
^f Unité Neurologie polyvalente, Département de neurologie, CHU de Rouen, Marseille, France
^g Service de Pathologie du mouvement–Neurologie, CHU de Strasbourg, Hôpital de Hautepierre, Marseille, France
^h Clinique neurologique, CHU de Nantes, Hôpital Nord Guillaume et René Laënnec, Marseille, France
ⁱ Service de Neurologie, CHU de Montpellier, Marseille, France
^j Service de Neurologie, CHU Amiens-Picardie - Site Sud, Marseille, France
^k Département de Neurologie, Hôpital Universitaire de la Pitié-Salpêtrière, APHP, Marseille, France
^l Service de Neurologie, Hôpital Sainte Musse, Toulon, France
^m Service de neurologie, CHU de Clermont-Ferrand, Hôpital Gabriel Montpied, Marseille, France
ⁿ Service de Neurologie, Hôpital Fondation Rothschild, Paris, France
^o Service de Neurologie, CHU de Nice, Marseille, France

^⁎Corresponding author. Service de Neurologie et Pathologies du Mouvement, CHU Timone, APHM, 68 Boulevard des Alpes, 13012 Marseille, France.Service de Neurologie et Pathologies du Mouvement, CHU Timone, APHM68 Boulevard des AlpesMarseille13012France

Highlights

•	The longitudinal validation implied 255 patients among 15 centers in France.
•	Non-motor fluctuations statistically separated into three distinct dimensions.
•	Sensory-pain fluctuations were associated with dysautonomic fluctuations.
•	Reproducibility and responsiveness were good for our questionnaire.
•	The questionnaire was validated according to standard metric criteria.

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Abstract

Introduction

Non-motor fluctuations (NMF) in Parkinson's disease (PD) remain poorly recognized but have a high impact on patients’ quality of life. The lack of assessment tools limits our understanding of NMF, compromising appropriate management. Our objective was to validate a hetero-questionnaire for NMF in PD patients at different stages of the disease: without treatment, without motor fluctuations, with motor fluctuations.

Methods

We included patients in 15 centers in France. Our questionnaire, NMF-Park, resulted from previous studies, allowing us to identify the more pertinent NMF for evaluation. Patients reported the presence (yes or no) of 22 selected NMF, and their link with dopaminergic medications. The assessment was repeated at one and two years to study the progression of NMF. We performed a metrological validation of our questionnaire.

Results

We included 255 patients (42 without treatment, 88 without motor fluctuations and 125 with motor fluctuations). After metrological validation, three dimensions of NMF were found: dysautonomic; cognitive; psychiatric. The sensory/pain dimension described in the literature was not statistically confirmed by our study.

Discussion

Our questionnaire was validated according to clinimetric standards, for different stages of PD. It was clinically coherent with three homogeneous dimensions. It highlighted a link between fatigue, visual accommodation disorder, and cognitive fluctuations; and the integration of sensory/pain fluctuations as part of dysautonomic fluctuations. It focused exclusively on NMF, which is interesting considering the described differences between non-motor and motor fluctuations.

Conclusion

Our study validated a hetero-questionnaire of diagnosis for NMF for different stages of PD.

Le texte complet de cet article est disponible en PDF.

Keywords : Parkinson's disease, Non-motor fluctuations, Questionnaire

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Vol 178 - N° 4

P. 347-354 - avril 2022 Retour au numéro

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Validation of a non-motor fluctuations questionnaire in Parkinson's disease - 09/05/22

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