Skip to main content
SpringerLink
Log in

Does WOQ-9 help to recognize symptoms of non-motor wearing-off in Parkinson’s disease?

  • Movement Disorders - Original Article
  • Published:
Journal of Neural Transmission Aims and scope Submit manuscript

Abstract

EWO (Epidemiology of Wearing-Off symptoms among the population of Parkinson’s disease (PD) patients on L-DOPA) is a multicentric, non-interventional, epidemiological and exploratory trial, focused on patients with PD who are treated with L-DOPA. The primary objective is the estimation of wearing-off symptoms (based on WOQ-9 questionnaire and assessment by neurologists) among PD patients who are treated with L-DOPA. From September 30, 2007 to June 30, 2008 altogether 563 valid records of PD patients were collected in movement disorders centers (Level A and Level B centers). Wearing-off symptoms were observed in 66.7% of PD patients (neurologists’ assessment) and in 90.6% of PD patients (WOQ-9 questionnaire). The biggest discrepancy was found in PD patients treated with L-DOPA for 0–2 years. The probability of detecting wearing-off by the neurologists strongly correlated with the highest number of positive responses in the WOQ-9 marked by PD patients. There was significant difference in the diagnosis of wearing-off between Level A centers (77.7%) and Level B centers (62.0%). When motor and non-motor symptoms in the WOQ-9 were considered, the difference between neurologists came from the detection of non-motor symptoms (lower in the Level B centers). The neurologists’ assessment of wearing-off symptoms and PD patients’ subjective evaluation of the WOQ-9 is based on the experience of the neurologist and on the detection of the non-motor symptoms of wearing-off. Careful explanation of the WOQ-9 questionnaire and improved awareness of the non-motor symptoms of wearing-off is strongly suggested.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  • Baker WL, Silver D, White CM, Kluger J, Aberle J, Patel AA, Coleman CI (2009) Dopamine agonists in the treatment of early Parkinson’s disease: a meta-analysis. Park Rel Dis 15:287–294

    Article  Google Scholar 

  • Bhidayasiri R, Truong DD (2008) Motor complications in Parkinson disease: clinical manifestations and management. J Neurol Sci 266:204–215

    Article  PubMed  Google Scholar 

  • Cheon SM, Ha MS, Park MJ, Kim JW (2008) Nonmotor symptoms of Parkinson’s disease: prevalence and awareness of patients and families. Park Rel Dis 14:286–290

    Article  Google Scholar 

  • Del Sorbo F, Albanese A (2008) Levodopa-induced dyskinesias and their management. J Neurol 255 (Suppl 4):32–41

    Article  PubMed  CAS  Google Scholar 

  • Dodel RC, Berger K, Oertel WH (2001) Health-related quality of life and healthcare utilisation in patients with Parkinson’s disease: impact of motor fluctuations and dyskinesias. Pharmacoeconomics 19:1013–1038

    Article  PubMed  CAS  Google Scholar 

  • Eggert K, Skogar O, Amar K, Luotonen L, Kuoppamäki M, Leinonen M, Nissinen H, Oertel W (2010) Direct switch from levodopa/benserazide or levodopa/carbidopa to levodopa/carbidopa/entacapone in Parkinson’s disease patients with wearing-off: efficacy, safety and feasibility–an open-label, 6-week study. J Neural Transm 117(3):333–342

    Article  PubMed  CAS  Google Scholar 

  • Fahn S (2005) Does levodopa slow or hastern the rate of progression of Parkinson’s disease? J Neurol 252(Suppl 4):37–42

    Google Scholar 

  • Fahn S, Oakes D, Shoulson I, Kieburtz K, Rudolph A, Lang A et al (2004) Levodopa and the progression of Parkinson’s disease. N Engl J Med 351(24):2498–2508

    Article  PubMed  CAS  Google Scholar 

  • Löhle M, Storch A, Reichmann H (2009) Beyond tremor and rigidity: non-motor features of Parkinson’s disease. J Neural Transm 116(11):1483–1492

    Article  PubMed  Google Scholar 

  • Martínez-Martín P, Tolosa E, Hernández B, Badia X, on behalf of the Spanish Wearing-off Study Group (2007) The patient card questionnaire to identify wearing-off in Parkinson′s Disease. Clin Neuropharmacol 30(5):266–275

    Google Scholar 

  • Martínez-Martín P, Tolosa E, Hernández B, Badia X, on behalf of the Spanish Wearing-off Study Group (2008) Validation of the “QUICK” questionnaire—a tool for diagnosis of “wearing-off” in patients with Parkinson′s Disease. Mov Disord 23(6):830–836

    Google Scholar 

  • Olanow CW, Stocchi F (2004) COMT inhibitors in Parkinson’s disease: can they prevent and/or reverse levodopa-induced motor complications?. Neurology 62(Suppl 1):S72–S81

    PubMed  CAS  Google Scholar 

  • Reichmann H, Ziemssen T (2009) Treatment strategies for nonmotor manifestations of Parkinson’s disease. Expert Opin Pharmacother 10(5):773–784 Review

    Article  PubMed  CAS  Google Scholar 

  • Reichmann H, Schneider C, Löhle M (2009) Non-motor features of Parkinson’s disease: depression and dementia. Parkinsonism Relat Disord 15(Suppl 3):S87–S92

    Article  PubMed  Google Scholar 

  • Růžička E, Streitová H, Jech R, Kaňovský P, Roth J, Rektorová I, Mečíř P, Bareš M, Hortová H, Hejduková B, Rektor I (2000) Amantadine-sulfate infusion in treatment of motor fluctuations and dyskinesias in Parkinson’s disease. J Neural Trans 107:1297–1306

    Article  Google Scholar 

  • Santens P, Maertens De Noordhout A (2006) for the Belgian EODWO study group. Detection of motor and non-motor symptoms of end-of dose wearing-off in Parkinson’s disease using a dedicated questionnaire : a Belgian multicenter survey. Acta Neurol Belg 106:137–141

    PubMed  Google Scholar 

  • Silburn PA, Mellick GD, Vieira BI, Danta G, Boyle RS, Herawati L (2008) Utility of a patient survey in identifying fluctuations in early stage Parkinson’s disease. J Clin Neurosci 15:1235–1239

    Article  PubMed  CAS  Google Scholar 

  • Stacy M (2010) The wearing-off phenomenon and the use of questionnaires to facilitate its recognition in Parkinson’s disease. J Neural Transm 117:837–846

    Article  PubMed  Google Scholar 

  • Stacy M, Hauser M (2007) Development of patient questionnaire to facilitate recognition of motor and non-motor wearing-off in Parkinson’s disease. J Neural Transm 114:211–217

    Article  PubMed  CAS  Google Scholar 

  • Stacy MA, Murphy JM, Greeley DR, Stewart RM, Murcke H, Menge X, on behalf of the COMPASS-I Study Investigators (2008) The sensitivity and specificity of the 9-item Wearing-off Questionnaire. Park Rel Dis 4:205–212

    Google Scholar 

  • Stacy M, Bowron A, Guttman M, Hauser R, Hughes K, Larsen JP, LeWitt P, Oertel W, Quinn N, Sethi K, Stocchi F (2005) Identification of motor and nonmotor wearing-off in Parkinson’s Disease: comparison of a patient questionnaire versus a clinician assessment. Mov Disord 20(6):726–733

    Article  PubMed  Google Scholar 

  • Stacy M, Hauser R, Oertel W, Schapira A, Sethi K, Stocchi F, Tolosa E (2006) End-of-dose wearing off in Parkinson Disease: a 9-question survey assessment. Clin Neuropharmacol 29(6):312–321

    Article  PubMed  Google Scholar 

  • Stacy MA, Murck H, Kroenke K (2010) Responsiveness of motor and nonmotor symptoms of Parkinson disease to dopaminergic therapy. Prog Neuropsychopharmacol Biol Psychiatry 34(1):57–61

    Article  PubMed  CAS  Google Scholar 

  • Stocchi F (2003) Prevention and treatment of motor fluctuations. Park Rel Dis 9(Suppl 2):73–81

    Article  Google Scholar 

  • Ward CD, Gibb WR (1990) Research diagnostic crieria for Parkinson’s disease. Adv Neurol 53:245–249

    PubMed  CAS  Google Scholar 

Download references

Acknowledgment

This non-interventional trial was sponsored by Novartis s.r.o., Czech Republic.

Finantial disclosures/Conflict of Interest concerning the research related to the manuscript:

No compensation was provided to Dr Bareš for his writing of this manuscript.

No compensation was provided to Drs Rektorová, Jech, Farníková, Roth, Růžička, Kaňovský, Rektor and Pavlík for their revision of the manuscript.

Drs Bareš, Rektorová, Jech, Farníková, Roth and Růžička received compensation from Novartis for their sites’ conduct of the study.

Leona Uhlířová and Jaroslav Vydlák are employees of Novartis.

Finantial disclosures:

Martin Bareš, MD, PhD:

Employment: Masaryk University Anne′s Hospital Brno

Advisory boards: Boehringer Ingelheim

Honoraria: personal compensations for activities with Novartis, Glaxo Smith Klein, Boehringer Ingelheim, Ipsen, Neomed, Medtronic, Solvay, Academia Pragensis

Grants: Czech Ministry of Education: Research program MŠM 0021622404

Clinical Trials: Allergan: 191622-090-00; Axxonis: CALIPSO study, Axxonis: TULEP Study, Synosia Therapeutics SYN118- CL03, Solvay: RELEVANT registry

Irena Rektorová, MD, PhD:

Employment: Masaryk University in Brno, St. Anne′s Hospital Brno

Honoraria: Lectures for Novartis, GSK, Pfizer, UCB, Glenmark, CR

Grants: Czech Ministry of Education: Research program MŠM 0021622404

Clinical Trials: Axxonis: CALIPSO study, Axxonis: TULEP study, JSW study

Robert Jech, MD, PhD:

Employment: Charles University in Prague, General Teaching hospital, Prague, Na Homolce Hospital, Prague

Honoraria: personal compensations for activities with Medtronic, Solvay, UCB, Novartis, Boehringer Ingelheim, Ipsen, Neomed,

Grants: Czech Ministry of Education: research program MŠM 0021620849; Czech Ministry of Health: grant IGA MZ 1A/8629-5, grant NR8937-4, grant NR/9220-3, NR/9215-3 and from the Grant Agency of Czech Republic: grant 309/09/1145.

Clinical Trials: Merz: MRZ 60201-0410, Allergan: 191622-057 and 191622-090-00; Solvay: RELEVANT registry; Axxonis: CALIPSO study

Kateřina Farníková, MD:

Employment: Palacky University in Olomouc, General University Hospital in Olomouc

Honoraria: Lectures for GSK and Novartis

Jan Roth, MD, CSc.:

Employment: Charles University in Prague, General University Hospital in Prague

Honoraria: from Boehringer Ingelheim, GSK, UCB and Novartis

Evžen Růžicka, MD, DrSc., FCMA

Employment: Charles University in Prague, General University Hospital in Prague

Grants: Czech Ministry of Health and Czech Ministry of Education. He is a member of a GSK advisory board and in the preceding 12 months, he has received honoraria or consulting fees from Boehringer Ingelheim, GSK and Medtronic

Petr Kaňovský, MD, CSc.:

Employment: Palacky University in Olomouc, University Hospital Olomouc

Consultancies: Merz, Allergan, ONO Pharma

Advisory Boards: GSK, Allergan

Honoraria: personal compensations for activities with Merz, Allergan, Ipsen, Novartis, GSK, Pfizer, Medtronic

Grants: Czech Ministry of Health IGA NS 9920

Clinical Trials: Merck Serono, BiogenIdec, Servier, Sanofi-Aventis, Novartis, GSK, Merz, Allergan, Ipsen, Boehringer Ingelheim, Solvay, Pierre Fabre, Pfizer

Ivan Rektor, MD, CSc.:

Employment: Masaryk University in Brno, St. Anne′s Hospital Brno

Honoraria: UCB, GSK, Ipsen

Grants: Research program of Czech Ministry for Education

Tomáš Pavlík, MSc, PhD:

Employment: Masaryk University Brno, St. Anne′s Hospital Brno, Faculty Hospital Brno

Honoraria: Sanofi-Aventis

Leona Uhlířová, MD, PhD:

Employment: Novartis s.r.o., Czech Republic

Jaroslav Vydlák, MD, Ing.:

Stock Ownership in medical fields: Novartis employee stock options

Employment: Novartis s.r.o., Czech Republic

Author information

Authors and Affiliations

  1. Movement Disorders Centre Brno and First Department of Neurology, Faculty of Medicine Masaryk University Brno, St. Anne’s Hospital Pekarska 53, 656 91, Brno, Czech Republic

    Martin Bareš, Irena Rektorová & Ivan Rektor

  2. Department of Neurology, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Prague, Czech Republic

    Robert Jech, Jan Roth & Evžen Růžička

  3. Department of Neurology, Faculty of Medicine Palacky University, Olomouc, Czech Republic

    Kateřina Farníková & Petr Kaňovský

  4. Institute of Biostatistics and Analyses, Masaryk University, Brno, Czech Republic

    Tomáš Pavlík

  5. Novartis s.r.o, Prague, Czech Republic

    Leona Uhlířová & Jaroslav Vydlák

Authors
  1. Martin Bareš
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Irena Rektorová
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Robert Jech
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kateřina Farníková
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jan Roth
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Evžen Růžička
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Petr Kaňovský
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Ivan Rektor
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Tomáš Pavlík
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Leona Uhlířová
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Jaroslav Vydlák
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Martin Bareš.

Additional information

This study is conducted on behalf of EWO study group.

Please refer the Appendix section for EWO study group members.

Appendix

Appendix

The other members of the EWO Study Group are:

Marek Baláž, Brno; Jan Bartoník, Kroměříž; Petra Bártová, Ostrava; Michal Bednář, Hradec Králové; Jiří Blažej, Kutná Hora; Martina Bočková, Brno; Jaroslava Budínská, Litoměřice; Vladko Bydžovský, České Budějovice; Eliška Debefová, Kroměříž; Václav Dostál, Pardubice; Klára Drugová, Praha; Petr Dušek, Praha; Naděžda Fišerová, Vyškov; Eva Formánková, České Budějovice; Martin Havlán, Chodov; Petra Havránková, Praha; Lenka Hlinková, Praha; Jakub Hort, Praha; Jaromír Houser, České Budějovice; Pavel Houška, Strakonice; Lucie Hrušková, Karlovy Vary; Helena Hyclová, Kladno; Zuzana Chovancová, Olomouc; Helena Chybová, Náchod; Michael Inneman, Kladno; Pavel Janouškovec, Plzeň; Markéta Jirásková, Praha; Kristina Jonsztová, Karviná; Zbyněk Kalita, Zlín; Gabriela Kamencová, Vsetín; Dagmar Kazdová, Žďár nad Sázavou; Jiří Klempíř, Praha; Lucie Kozlová, Ústí nad Labem; Andrea Krompolcová, Nový Jičín; Margareta Krupová, Nový Jičín; Blanka Kykalová, Praha; Jana Letáková, Praha; Pavel Lindovský, Praha; Vojtěch Mach, Plzeň; Taťjana Majorová, Praha; Jarmila Maňhalov, Trutnov; Zuzana Matoušová, Praha; Hana Melšová, Děčín; Blanka Mistríková, Zlín; Jiří Neumann, Chomutov; Martin Nevrlý, Olomouc; Dana Nováčková, Český Krumlov; Lucie Nováková, Praha; Václav Ondřich, Brno; Eva Paseková, Praha; Kateřina Pavlosková, Ostrava; Lenka Peníšková, Liberec; Jan Peregrin, Praha; Alena Pospíšilová, Praha; Irena Pozděnová, Plzeň; Jozef Pribula, Litoměřice; Petr Procházka, Zlín; Jaroslav Rach, Strakonice; Daniel Rosol, Prachatice; Danuše Roubcová, Ostrava; Tereza Serranová, Praha; Světlana Skutilová, Brno; Stanislav Slavík, Most; Jana Sobotová, Plzeň; Helena Straková, Chomutov; Hana Streitová, Brno; Lenka Svatíková, Přerov; Jindra Svátová, Praha; Věnceslava Svobodová, Praha; Dáša Sýkorová, Ostrava; Radim Szotkowski, Přerov; Monika Šimečková, Kadaň; Václav Tomášek, Praha; Zdeněk Topinka, Kolín; Olga Ulmanová, Praha; Martina Vančurová, Teplice; Tomáš Vodvářka, Ostrava; Hana Vránová, Olomouc; Dana Vyskočilová, Praha; Oldřich Vyšata, Rychnov nad Kněžnou; Antonín Wierer, České Budějovice; Kateřina Zárubová, Praha; Richard Zindr, Karlovy Vary.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bareš, M., Rektorová, I., Jech, R. et al. Does WOQ-9 help to recognize symptoms of non-motor wearing-off in Parkinson’s disease?. J Neural Transm 119, 373–380 (2012). https://doi.org/10.1007/s00702-011-0683-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00702-011-0683-9

Keywords

Search

Navigation