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Parkinson’s Disease
Volume 2011, Article ID 292719, 13 pages
Research Article

Development of a Non-Motor Fluctuation Assessment Instrument for Parkinson Disease

1Baycrest Hospital, University of Toronto, 3560 Bathurst Street, Toronto, ON, Canada M6A 2E1
2Parkinson's Disease Research Education and Clinical Center (PADRECC), Philadelphia VA Medical Center, Philadelphia, PA 19107, USA
3Toronto Western Hospital, University of Toronto, Toronto, ON, Canada M5I 2S8
4School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA

Received 25 April 2011; Accepted 24 May 2011

Academic Editor: Alan R. Crossman

Copyright © 2011 Galit Kleiner-Fisman et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Patients with Parkinson disease are increasingly recognized to suffer from non-motor symptoms in addition to motor symptoms. Many non-motor symptoms fluctuate in parallel with motor symptoms and in relationship to plasma levodopa levels. Though these symptoms are troublesome and result in reduced quality of life to patients and their caregivers, there has not been an objective method of recognizing and quantifying non-motor fluctuations (NMFs). This study sought to develop a patient-based instrument that would accurately capture the experience of patients with NMFs. Patient-based nominal group technique sessions, focus groups, and expert opinion were utilized in developing this questionnaire.