Focus on Symptom Fluctuations in Parkinson’s Disease

Parkinson’s disease (PD) is a progressive, neurodegenerative disease with debilitating motor symptoms including tremor, stiffness, and a slowing of movements called bradykinesia. PD often includes underrecognized non-motor symptoms such as pain, constipation, urinary incontinence, cognitive impairment, and changes in mood (e.g., anxiety, depression). These motor and non-motor symptoms can become increasingly bothersome over time and first-line medications for PD, such as levodopa, may no longer control symptoms at previously effective doses. Individuals may experience fluctuations between good symptom control called “on” times and worsening symptoms or “off” times. These fluctuations may also be referred to as wearing off, motor fluctuation, or “on-off” and can limit one’s ability to participate in self-care and daily activities. Symptom fluctuations can vary in frequency and intensity. For some, they are predictable, where symptoms increase between medication doses or at a particular time of day (e.g., early morning stiffness). For others, “off” episodes can be unpredictable and quite severe, including a temporary but highly debilitating condition referred to as “freezing” where individuals experience a nearly complete inability to move parts of their body.

Download the August 2021 issue of HealthLine to read the full article.