title: Non-motor fluctuations in Parkinson's disease: prevalence, characteristics and management in a large cohort of parkinsonian outpatients.
abstract: OBJECTIVE
  To describe demographic and clinical characteristics in a group of Parkinson's disease (PD) patients with non-motor fluctuations (NMF) and to evaluate the management of medications proposed to treat NMF.
  
  
  METHODS
  Three hundred and three PD patients (mean age, 66 ± 10.3 years; mean disease duration, 10.1 ± 6.5 years) were enrolled. Each patient was interviewed in a non-directed fashion about the main NMF manifestations, i.e. dysautonomic, mental, and sensory symptoms. Both groups of patients with and without NMF were compared. Dysautonomia, motor fluctuations, age, disease duration, and LEDD were included in a multiple regression to determine which were predictive of NMF.
  
  
  RESULTS
  NMF were found in 57 (19%) patients, mean age 65 ± 10.1 years, mean age at onset of PD 53.7 ± 10.9 years, mean disease duration 12.5 ± 6.9 years. NMF occurred on average 9.8 ± 7.7 years after the onset of PD. Fifty patients (86%) with NMF had also MF and 10 (21%) had PDD. Twenty-five (44%) patients suffered from sensory, 28 (49%) from autonomic and 25 (44%) from neuropsychiatric symptoms. Both disease and L-Dopa treatment durations, and LEDD were significantly higher in NMF patient's group. Motor fluctuations (p = 0.0016) and presence of dysautonomia (p = 0.007) were found to be two independent predictors of NMF.
  
  
  CONCLUSIONS
  The development of new instruments to assess NMF is crucial for optimized management of advanced PD.
authors.affiliation: Department of Neurology, Rouen University Hospital and University of Rouen, Rouen, France.
authors.forename: Lucile
authors.initials: L
authors.lastname: Brun
authors.affiliation: Department of Neurology, Rouen University Hospital and University of Rouen, Rouen, France.
authors.forename: Romain
authors.initials: R
authors.lastname: Lefaucheur
authors.affiliation: Department of Neurology, Rouen University Hospital and University of Rouen, Rouen, France.
authors.forename: Damien
authors.initials: D
authors.lastname: Fetter
authors.affiliation: Department of Neurosurgery, Rouen University Hospital and University of Rouen, Rouen, France.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Derrey
authors.affiliation: Department of Neurology, Rouen University Hospital and University of Rouen, Rouen, France.
authors.forename: Alaina
authors.initials: A
authors.lastname: Borden
authors.affiliation: Department of Neurology, Rouen University Hospital and University of Rouen, Rouen, France.
authors.forename: David
authors.initials: D
authors.lastname: Wallon
authors.affiliation: Department of Neurology, Rouen University Hospital and University of Rouen, Rouen, France.
authors.forename: Bertrand
authors.initials: B
authors.lastname: Bourre
authors.affiliation: Department of Neurology, Rouen University Hospital and University of Rouen, Rouen, France; INSERM U1079, Rouen Faculty of Medicine, Rouen, France. Electronic address: david.maltete@chu-rouen.fr.
authors.forename: David
authors.initials: D
authors.lastname: Maltête
mesh_terms: D000367:Age Factors; D000368:Aged; D000978:Antiparkinson Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D019090:Case Management; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007980:Levodopa / Q000008:administration & dosage / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009069:Movement Disorders / Q000453:epidemiology / Q000209:etiology; D010300:Parkinson Disease / Q000188:drug therapy / Q000453:epidemiology* / Q000503:physiopathology*; D054969:Primary Dysautonomias / Q000453:epidemiology / Q000209:etiology
chemical_list: D000978:Antiparkinson Agents; D007980:Levodopa
keywords: Motor fluctuations; Non-motor fluctuations; Parkinson's disease