Objective: To evaluate the demographic and clinical correlates of Parkinson’s disease (PD) patients with fluctuations of neuropsychiatric symptoms (NPS-F).

Background: Clinical correlates of fluctuations of neuropsychiatric symptoms (NPS-F) are unknown in Parkinson’s disease (PD).

Method: We enrolled consecutive subjects with moderate PD. The Wearing-Off Questionnaire (WOQ-19), PD sleep scale 2 (PDSS-2) 39-item PD Questionnaire (PDQ-39), Hamilton depression and anxiety rating scale (HDRS and HARS) were administered.

At home assessment for 5 days by the PKG®, an accelerometry-based system for detection of motor fluctuations was employed in each subject. A score ≥ 1 in one of the items of the WOQ-19 (3,5,12,13) for neuropsychiatric symptoms defined the presence of NPS-F.

Results: Out of 93 PD patients included (32 females, age 61.9±6.9 years, disease duration 10.4±4.6 years), 63 (68%) had NPS-F. Compared to subjects without neuropsychiatric fluctuations, PD with NPS-F has the following features: more severe anxiety (HARS, p=0.001) and depression (HDRS p=0.001); poorer quality of life (PDQ-39: p=0.02), more severe sleep disturbances (PDSS-2: p=0.02). They also presented higher scores at WOQ-19 for autonomic, sensorial and motor fluctuations (p=0.01: p=0.001 p=0.02). Objective assessment of wearing off by PKG showed that PD with NPS-F had fewer motor fluctuations and off-time (BK50: p=0.034).

Conclusion: NPS-F in PD occur in the context of less severe motor fluctuations and off-time as per objective assessment via a wearable sensor. Yet, they are associated with high burden of anxiety and depression and with fluctuations in the autonomic and sensory domain.

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