Daniel J van Wamelen1,2,3, Daniele Urso1,2, K Ray Chaudhuri1,2. 1. King's College London, Department of Neurosciences, Institute of Psychiatry, Psychology & Neuroscience, De Crespigny Park, London, United Kingdom. 2. Parkinson Foundation Centre of Excellence, King's College Hospital, Denmark Hill, London, United Kingdom. 3. Radboud University Medical Centre; Donders Institute for Brain, Cognition and Behaviour; department of neurology; Nijmegen, the Netherlands.
Abstract
BACKGROUND: Several small-scale studies have shown that motor performance in Parkinson's disease (PD) fluctuates throughout the day. Studies specifically focusing on de novo patients are, however, lacking. OBJECTIVE: To evaluate the effect of clock time on motor performance in de novo drug-naïve patients with PD. METHODS: We retrieved MDS-UPDRS III scores for 421 de novo PD patients from the PPMI cohort and stratified them into three groups based on time of assessment: group 1) 7:00-10:00; group 2) 10:00-13:00, and group 3) 13:00-18:00. Groups were compared using Kruskal-Wallis test and results corrected for multiple testing. In addition, we obtained 27 wearable sensor reports, objectively capturing bradykinesia scores in a home setting over a 6-day continuous period, in 12 drug-naïve patients from the Parkinson's Kinetigraph Registry held at King's College Hospital London. Time spent in severe bradykinesia scores were broken down into five daytime (06:00-21:00) three-hourly epochs and scores compared using the Friedman test. RESULTS: There were no group differences in demographic or other clinical variables for the cross-sectional analysis. MDS-UPDRS III total scores worsened significantly during the course of the day (median 18 (group 1); 20 (group 2); and 23 (group 3); p = 0.001). In the longitudinal wearable sensor cohort, diurnal variations were present in percentage of time spent in severe bradykinesia (p < 0.001) with the lowest percentage during the 09:00-12:00 epoch (69.56±16.68%), when most patients are awake and start daily activity, and the highest percentage during the 18:00-21:00 epoch (73.58±16.35%). CONCLUSION: This exploratory study shows the existence of a diurnal pattern of motor function in patients with de novo PD. The results obtained were corroborated by objective measurements in a small longitudinal cohort confirming a similar diurnal motor score variation.
BACKGROUND: Several small-scale studies have shown that motor performance in Parkinson's disease (PD) fluctuates throughout the day. Studies specifically focusing on de novo patients are, however, lacking. OBJECTIVE: To evaluate the effect of clock time on motor performance in de novo drug-naïve patients with PD. METHODS: We retrieved MDS-UPDRS III scores for 421 de novo PD patients from the PPMI cohort and stratified them into three groups based on time of assessment: group 1) 7:00-10:00; group 2) 10:00-13:00, and group 3) 13:00-18:00. Groups were compared using Kruskal-Wallis test and results corrected for multiple testing. In addition, we obtained 27 wearable sensor reports, objectively capturing bradykinesia scores in a home setting over a 6-day continuous period, in 12 drug-naïve patients from the Parkinson's Kinetigraph Registry held at King's College Hospital London. Time spent in severe bradykinesia scores were broken down into five daytime (06:00-21:00) three-hourly epochs and scores compared using the Friedman test. RESULTS: There were no group differences in demographic or other clinical variables for the cross-sectional analysis. MDS-UPDRS III total scores worsened significantly during the course of the day (median 18 (group 1); 20 (group 2); and 23 (group 3); p = 0.001). In the longitudinal wearable sensor cohort, diurnal variations were present in percentage of time spent in severe bradykinesia (p < 0.001) with the lowest percentage during the 09:00-12:00 epoch (69.56±16.68%), when most patients are awake and start daily activity, and the highest percentage during the 18:00-21:00 epoch (73.58±16.35%). CONCLUSION: This exploratory study shows the existence of a diurnal pattern of motor function in patients with de novo PD. The results obtained were corroborated by objective measurements in a small longitudinal cohort confirming a similar diurnal motor score variation.
Entities:
Keywords:
Parkinson’s disease; bradykinesia; circadian rhythm; diurnal rhythm; motor
Authors: Daniel Johannes van Wamelen; Silvia Rota; Anette Schrag; Alexandra Rizos; Pablo Martinez-Martin; Daniel Weintraub; Kallol Ray Chaudhuri Journal: Mov Disord Clin Pract Date: 2022-08-05
Authors: Silvia Rota; Daniele Urso; Daniel J van Wamelen; Valentina Leta; Iro Boura; Per Odin; Alberto J Espay; Peter Jenner; K Ray Chaudhuri Journal: Transl Neurodegener Date: 2022-10-13 Impact factor: 9.883