Responsiveness of motor and nonmotor symptoms of Parkinson disease to dopaminergic therapy.
BACKGROUND
The duration of clinical control of motor symptoms of Parkinson disease (PD) treated with levodopa/carbidopa preparations eventually starts to shorten, a phenomenon known as end-of-dose "wearing off." The involvement of core nonmotor symptoms of "wearing off" (depressed mood, pain/aching, anxiety, and cloudy/slowed thinking) is not well understood.


METHODS
A post hoc analysis from a study to validate the self-rated 9-item, Wearing-Off Questionnaire (WOQ-9), which was designed to identify motor and nonmotor symptoms of "wearing off" in PD patients, was performed to compare the frequency and sensitivity of motor and nonmotor symptoms of "wearing off" from dopaminergic therapy.


RESULTS
Analysis of responses to the WOQ-9 from 216 PD patients found that individual nonmotor symptoms were reported by 25% to 50% and motor symptoms by 55% to 80% of patients. Individual nonmotor symptoms improved following the next dose of dopaminergic therapy in 43% to 53% of the patients who presented with such symptoms, whereas motor symptoms improved in 48% to 66% of the cases, suggesting both types of symptoms respond to dopaminergic therapies.


CONCLUSIONS
Nonmotor symptoms of PD appear sensitive to dopaminergic treatment. These symptoms resemble those seen with depressive, anxiety, and somatoform disorders suggesting potential shared mechanisms as well as possible treatment implications.
Division of Neurology, Duke University, 932 Morreene Rd, MS 3333, Durham, NC 27705, USA. stacy002@mc.duke.edu
Mark A
MA
Stacy
Harald
H
Murck
Kurt
K
Kroenke
D000203:Activities of Daily Living; D001526:Behavioral Symptoms / Q000188:drug therapy* / Q000209:etiology; D002230:Carbidopa / Q000627:therapeutic use; D004185:Disability Evaluation; D015259:Dopamine Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007980:Levodopa / Q000627:therapeutic use; D008297:Male; D009043:Motor Activity / Q000187:drug effects*; D017063:Outcome Assessment, Health Care; D010300:Parkinson Disease / Q000150:complications / Q000188:drug therapy*; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
D015259:Dopamine Agents; D007980:Levodopa; D002230:Carbidopa