Motor and Non-Motor Wearing-off Impact Quality of Life in Parkinson, Study Finds

A study aiming to evaluate the impact of motor and non-motor wearing-off—a common phenomenon in Parkinson disease (PD)—found that the fluctuations have an impact on the activities of daily living and quality of life, with non-motor wearing-off having the greater impact.

The study defined wearing-off as a predictable recurrence of motor and non-motor symptoms preceding scheduled doses of antiparkinsonian medication. The researchers performed a cross-sectional study using the Movement Disorders Society Unified Parkinson’s Disease Rating Scale. The Wearing-Off Questionnaire-19 was used to assess wearing-off, while the Parkinson’s Disease Questionnaire-8 was used to measure quality of life.

“Motor fluctuations in Parkinson’s disease (PD) have been extensively studied. Conversely, less is known about the behavior of non-motor symptoms in relation to the “on” and “off” periods. While some authors have suggested that these non-motor fluctuations correlate closely with motor fluctuations, the heterogeneity of study designs and differences in sample populations complicate the generalization of these results,” explained the authors. “In addition, non-motor symptoms have an important impact on quality of life and, in some cases, their burden can be more disabling when compared with motor symptoms.”

Of the 271 patients who were included in the study, 73.4% had wearing-off and 46.8% had both motor and non-motor fluctuations. Of those with both motor and non-motor, wearing-off had a worse quality of life compared with those with only motor fluctuations.

“Wearing-off symptoms have implications in health-related quality of life. Non-motor symptoms have been clearly associated with a decrease in the quality of life. Nonetheless, there is less evidence regarding the impact of non-motor fluctuations and quality of life,” noted the authors. “Patients with no wearing-off and those with only motor wearing-off had a better quality of life. This finding suggests that, in fact, non-motor fluctuations may yield a higher impact on the quality of life than motor wearing-off symptoms.”

The authors suggested that future studies confirming their results are necessary because their results were limited in size and did not analyze individual non-motor fluctuations that may have occurred.