Emmanuelle Schmitt1,2,3, Paul Krack1,2,3,4, Anna Castrioto1,2,3, Helene Klinger5,6,7, Amelie Bichon1,2,3, Eugénie Lhommée1,2,3, Pierre Pelissier1,2,3, Valerie Fraix1,2,3, Stephane Thobois5,6,7, Elena Moro1,2,3, Pablo Martinez-Martin8,9. 1. Movement Disorders Unit, Department of Psychiatry Neurology and Neurological Rehabilitation CHU Grenoble Grenoble France. 2. Grenoble Institut des Neurosciences Grenoble Alpes University France. 3. Inserm U1216 Grenoble France. 4. Department of Clinical Neuroscience, Hôpitaux Universitaires de Genève University of Geneva Switzerland. 5. Hospices Civils de Lyon, Hôpital Neurologique Neurologie C Lyon France. 6. Faculté de Médecine et de Maïeutique Lyon Sud Charles Mérieux, Université de Lyon 1 Université de Lyon Lyon France. 7. CNRS, UMR 5229 Centre de Neurosciences Cognitives Bron France. 8. National Center of Epidemiology Carlos III Institute of Health Madrid Spain. 9. CIBERNED Carlos III Institute of Health Madrid Spain.
Abstract
BACKGROUND: Non-motor fluctuations represent a main source of disability in Parkinson's disease (PD). Among them, neuropsychiatric fluctuations are the most frequent and are often under-recognized by patients and physicians, partly because specific tools for assessment of neuropsychiatric fluctuations are lacking. OBJECTIVE: To develop a scale for detecting and evaluating the presence and the severity of neuropsychological symptoms during the ON and OFF phases of non-motor fluctuations. METHODS: Neuropsychiatric symptoms reported by PD patients in the OFF- and the ON-medication conditions were collected using different neuropsychiatric scales (BDI-II, BAI, Young, VAS, etc.). Subsequently, tree phases of a pilot study was performed for cognitive pretesting, identification of ambiguous or redundant items (item reduction), and to obtain preliminary data of acceptability of the new scale. In all the three phases, the scale was applied in both the OFF and ON condition during a levodopa challenge. RESULTS: Twenty items were selected for the final version of the neuropsychiatric fluctuation scale (NFS): ten items measured the ON neuropsychological symptoms and ten items the OFF neuropsychological manifestations. Each item rated from 0-3, providing respective subscores from 0 to 30. CONCLUSIONS: Once validated, our NFS can be used to identify and quantify neuropsychiatric fluctuations during motor fluctuations. The main novelty is that it could be used in acute settings. As such, the NFS can assess the neuropsychiatric state of the patient at the time of examination. The next step will be to validate the NFS to be used in current practice.
BACKGROUND: Non-motor fluctuations represent a main source of disability in Parkinson's disease (PD). Among them, neuropsychiatric fluctuations are the most frequent and are often under-recognized by patients and physicians, partly because specific tools for assessment of neuropsychiatric fluctuations are lacking. OBJECTIVE: To develop a scale for detecting and evaluating the presence and the severity of neuropsychological symptoms during the ON and OFF phases of non-motor fluctuations. METHODS: Neuropsychiatric symptoms reported by PD patients in the OFF- and the ON-medication conditions were collected using different neuropsychiatric scales (BDI-II, BAI, Young, VAS, etc.). Subsequently, tree phases of a pilot study was performed for cognitive pretesting, identification of ambiguous or redundant items (item reduction), and to obtain preliminary data of acceptability of the new scale. In all the three phases, the scale was applied in both the OFF and ON condition during a levodopa challenge. RESULTS: Twenty items were selected for the final version of the neuropsychiatric fluctuation scale (NFS): ten items measured the ON neuropsychological symptoms and ten items the OFF neuropsychological manifestations. Each item rated from 0-3, providing respective subscores from 0 to 30. CONCLUSIONS: Once validated, our NFS can be used to identify and quantify neuropsychiatric fluctuations during motor fluctuations. The main novelty is that it could be used in acute settings. As such, the NFS can assess the neuropsychiatric state of the patient at the time of examination. The next step will be to validate the NFS to be used in current practice.
Authors: F Ory Magne; C Arcari; C Canivet; M Sarrail; M H Fabre; C Mohara; C Brefel Courbon Journal: Rev Neurol (Paris) Date: 2013-11-20 Impact factor: 2.607
Authors: M Skorvanek; Z Gdovinova; J Rosenberger; R Ghorbani Saeedian; I Nagyova; J W Groothoff; J P van Dijk Journal: Acta Neurol Scand Date: 2014-10-06 Impact factor: 3.209
Authors: K Ray Chaudhuri; Anette Schrag; Daniel Weintraub; Alexandra Rizos; Carmen Rodriguez-Blazquez; Eugenia Mamikonyan; Pablo Martinez-Martin Journal: Mov Disord Date: 2019-09-30 Impact factor: 10.338
Authors: Gregory M Pontone; Nadeeka Dissanayka; Liana Apostolova; Richard G Brown; Roseanne Dobkin; Kathy Dujardin; Joseph H Friedman; Albert F G Leentjens; Eric J Lenze; Laura Marsh; Lynda Mari; Oury Monchi; Irene H Richard; Anette Schrag; Antonio P Strafella; Beth Vernaleo; Daniel Weintraub; Zoltan Mari Journal: NPJ Parkinsons Dis Date: 2019-12-11