International multicenter pilot study of the first comprehensive self-completed nonmotor symptoms questionnaire for Parkinson's disease: The NMSQuest study

Baylor College of Medicine, Houston, Texas, United States
Movement Disorders (Impact Factor: 5.68). 07/2006; 21(7):916-23. DOI: 10.1002/mds.20844
Source: PubMed


Nonmotor symptoms (NMS) of Parkinson's disease (PD) are not well recognized in clinical practice, either in primary or in secondary care, and are frequently missed during routine consultations. There is no single instrument (questionnaire or scale) that enables a comprehensive assessment of the range of NMS in PD both for the identification of problems and for the measurement of outcome. Against this background, a multidisciplinary group of experts, including patient group representatives, has developed an NMS screening questionnaire comprising 30 items. This instrument does not provide an overall score of disability and is not a graded or rating instrument. Instead, it is a screening tool designed to draw attention to the presence of NMS and initiate further investigation. In this article, we present the results from an international pilot study assessing feasibility, validity, and acceptability of a nonmotor questionnaire (NMSQuest). Data from 123 PD patients and 96 controls were analyzed. NMS were highly significantly more prevalent in PD compared to controls (PD NMS, median = 9.0, mean = 9.5 vs. control NMS, median = 5.5, mean = 4.0; Mann-Whitney, Kruskal-Wallis, and t test, P < 0.0001), with PD patients reporting at least 10 different NMS on average per patient. In PD, NMS were highly significantly more prevalent across all disease stages and the number of symptoms correlated significantly with advancing disease and duration of disease. Furthermore, frequently, problems such as diplopia, dribbling, apathy, blues, taste and smell problems were never previously disclosed to the health professionals.

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Available from: Kallol Ray Chaudhuri, Sep 29, 2015
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    • "Two dichotomous items on anxiety and orthostatism (no. 17 and 20) of the Nonmotor Symptoms Questionnaire (NMSQuest) [36] were also included. In addition, the Geriatric Depression Scale (GDS-15) [37] was administered as an interview. "
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    ABSTRACT: Fear of falling can be conceptualized in different ways, e.g., as concerns about falling or low fall-related self-efficacy. It is common in people with Parkinson's disease (PD), and there is growing knowledge about its contributing factors. However, previous multivariate studies have mainly focused on fear of falling in relation to PD-related disabilities, and less is known about the associations between fear of falling and personal and environmental factors. To identify explanatory factors of concerns about falling in people with PD by focusing on personal and environmental factors as well as PD-related disabilities. Data were collected from 241 persons with PD (39% women, median age 70 years, PD duration 8 years). Concerns about falling (assessed with the Falls Efficacy Scale-International, FES-I; categorized into low, moderate, or high concerns) were used as the dependent variable in a multivariate ordinal regression analysis. Personal factors, environmental factors and PD-related disabilities constituted independent variables. Low, moderate and high concerns about falling were reported by 29%, 24% and 47% of the participants, respectively. Walking difficulties, orthostatism, motor symptoms, age, and fatigue (presented in order of importance) were significant (p < 0.05) explanatory factors of concerns about falling. Several factors significantly explained concerns about falling in people with PD. Walking difficulties was by far the strongest explanatory factor. This suggests that minimizing walking difficulties should be a primary target when aiming at reducing concerns about falling in people with PD.
    04/2015; 5(2). DOI:10.3233/JPD-140524
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    • "NA Note. PD ON ϭ patients with Parkinson's disease on medication; HCϭ healthy controls; SF-36 ϭ 36-Item Short-Form Health Survey (Ware & Sherbourne, 1992); PCS ϭ SF-36-Physical Component Summary; MCS ϭ SF-36-Mental Component Summary; BDI ϭ Beck Depression Inventory (Beck, Ward, Mendelson, Mock, & Erbaugh, 1961); BIS-11 ϭ Barratt Impulsiveness Scale-11 (Patton, Stanford, & Barratt, 1995); UPDRS ϭ Unified Parkinson's Disease Rating Scale (Fahn & Elton, 1987); NA ϭ not applicable; NMS-PD ϭ Nonmotor Symptoms Questionnaire for Parkinson's Disease (Chaudhuri et al., 2006 "
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    ABSTRACT: Objective: The study was designed to examine persistent (input selection) versus transient (input shifting) mechanisms of attention control in Parkinson's disease (PD). Method: The study identifies behavioral and neural markers of selective control and shifting control using a novel combination of a flanker task with an attentional set-shifting task, and it compares patients with PD with matched controls. Event-related brain potentials (ERPs) were recorded, and analyses focused on frontally distributed N2 waves, parietally distributed P3 waves, and error-related negativities (Ne/ERN). Results: Controls showed robust shifting costs (prolonged response times), but patients with PD did not show evidence for comparable shifting costs. Patients with PD made more errors than controls when required to shift between attentional sets, but also when they had to initially maintain an attentional set. At the neural level it was found that contrary to controls, patients with PD did not display any N2 and P3 augmentations on shift trials. Patients with PD further did not display any error-related activity or posterror N2 augmentation. Conclusions: Our results reveal that intact selective control and disrupted shifting control are dissociable in patients with PD, but additional work is required to dissect the proportionate effects of disease and treatment on shifting control in PD. Our ERP-based approach opens a new window onto an understanding of motor and cognitive flexibility that seems to be associated with the dopaminergic innervation of cortico-striatal loops.
    Neuropsychology 11/2014; DOI:10.1037/neu0000099 · 3.27 Impact Factor
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    • "However, the fact that NMS may arise as part of drug related effects and side effects confounds this issue further. Recently, the importance of measuring NMS using validated tools, such as the NMS Questionnaire (NMSQuest) [6] and the NMS Scale (NMSS) [7] has been described in two independent case control studies in drug na¨ıve PD [8] and early PD [9] patients. "
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    ABSTRACT: Background: Recent studies have demonstrated that, contrary to common perception non-motor symptoms (NMS) occur and may dominate early and untreated stage of Parkinson's disease (PD). Objective: The aim of this ongoing study was to describe the overall NMS profile and burden in drug naïve PD patients (DNPD) compared to a group of long-term PD patients (LTPD, disease duration ≥15 years). Methods: Cross sectional UK data from a multicenter (16 sites) collaboration were obtained and specifically NMS dataset from validated scales were analysed in DNPD and LTPD patients. The NMS scale (NMSS) was used as the primary outcome variable. Results: Out of a current database of 468 PD patients, 57 were DNPD (58% males, mean age 64.8 years, median Hoen and Yahr stage 1) and 25 were LTPD (44%, mean age 67.6 years, median Hoen and Yahr stage 3). DNPD patients had a significantly lower (p = 0.001) NMSS score (mean 45.5, range 1-150) compared to the LTPD patients (mean 74.0, range 6-155), but 26.3% had severe and 19.3% had very severe burden of NMSS using NMSS cutoff scores. In comparison, 20.0% of the LTPD patients had severe and 60.0% very severe burden of NMS (p = 0.003). Conclusions: NMS are common in DNPD patients and over 45% may have severe to very severe burden of NMS, which is a key determinant of quality of life. In LTPD patients not only the burden of "very severe" NMS is significantly higher, but there are also differences in the profile of expression of NMS.
    Journal of Parkinson's Disease 06/2014; 4(3). DOI:10.3233/JPD-140372 · 1.91 Impact Factor
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