End-of-dose wearing off in parkinson disease: A 9-question survey assessment

Mark Stacy, Robert Hauser, Wolfgang Oertel, Anthony Schapira, Kapil Dev Sethi, Fabrizio Stocchi, Eduardo Tolosa

Research output: Contribution to journalArticle

46 Citations (Scopus)

Abstract

We have previously reported that the use of a 32-symptom Wearing-off Questionnaire (WOQ-32) identified wearing off more frequently than a clinician's evaluation or the complications subscale of the Unified Parkinson Disease Rating Scale (UPDRS). However, this prototype tool was not designed for clinical practice and required simplification for daily use. Although wearing off is a commonly understood concept among neurologists caring for Parkinson disease patients, there are a number of definitions in the literature. For the purpose of this study and to include both motor and nonmotor parkinsonian symptoms, wearing off was defined as a generally predictable recurrence of motor and nonmotor symptoms that precedes scheduled doses of anti-parkinsonian medication and usually improves after those doses. Using this definition, retrospective analysis and expert opinion were used to identify the 9 most predictive and relevant of the symptoms previously identified as part of the WOQ-32. The resulting 9-symptom questionnaire (WOQ-9) identified 158 (95.8%) of the 165 subjects captured by the 32-Symptom Wearing-off Questionnaire as having wearing off, excluding 7 subjects reporting only balance difficulty (n = 3), numbness (n = 2), difficulty standing (n = 1), and abdominal discomfort (n = 1). Subjects reporting wearing off with the WOQ-9 were significantly younger, had been longer diagnosed with Parkinson disease, experienced a longer duration of levodopa therapy, exhibited a higher UPDRS total score, had higher levodopa equivalent dosages, and increased dyskinesia compared with patients not identified as wearing off with the WOQ-9. No statistical differences were noted with respect to sex, UPDRS subsection scores, Schwab & England Scale, or Hoehn & Yahr Scale.

Original languageEnglish (US)
Pages (from-to)312-321
Number of pages10
JournalClinical Neuropharmacology
Volume29
Issue number6
DOIs
StatePublished - Nov 1 2006

Fingerprint

Parkinson Disease
Levodopa
Hypesthesia
Dyskinesias
Expert Testimony
England
Surveys and Questionnaires
Kufor-Rakeb syndrome
Recurrence
Therapeutics

Keywords

  • Motor fluctuations
  • Nonmotor fluctuations
  • Parkinson disease
  • Wearing off

ASJC Scopus subject areas

  • Pharmacology
  • Clinical Neurology
  • Pharmacology (medical)

Cite this

Stacy, M., Hauser, R., Oertel, W., Schapira, A., Sethi, K. D., Stocchi, F., & Tolosa, E. (2006). End-of-dose wearing off in parkinson disease: A 9-question survey assessment. Clinical Neuropharmacology, 29(6), 312-321. https://doi.org/10.1097/01.WNF.0000232277.68501.08

End-of-dose wearing off in parkinson disease : A 9-question survey assessment. / Stacy, Mark; Hauser, Robert; Oertel, Wolfgang; Schapira, Anthony; Sethi, Kapil Dev; Stocchi, Fabrizio; Tolosa, Eduardo.

In: Clinical Neuropharmacology, Vol. 29, No. 6, 01.11.2006, p. 312-321.

Research output: Contribution to journalArticle

Stacy, M, Hauser, R, Oertel, W, Schapira, A, Sethi, KD, Stocchi, F & Tolosa, E 2006, 'End-of-dose wearing off in parkinson disease: A 9-question survey assessment', Clinical Neuropharmacology, vol. 29, no. 6, pp. 312-321. https://doi.org/10.1097/01.WNF.0000232277.68501.08
Stacy, Mark ; Hauser, Robert ; Oertel, Wolfgang ; Schapira, Anthony ; Sethi, Kapil Dev ; Stocchi, Fabrizio ; Tolosa, Eduardo. / End-of-dose wearing off in parkinson disease : A 9-question survey assessment. In: Clinical Neuropharmacology. 2006 ; Vol. 29, No. 6. pp. 312-321.
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