Journal Article (Review Article)

DZNE-2026-01150

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Not always the usual suspect: symptom variations in Parkinson's disease beyond ON-OFF fluctuations.

Ebersbach, G. ; Jost, W. H. ; Koschel, J. ; Müller, R. ; Paus, S. ; Urban, P. P. ; Poewe, W. ; Storch, A. (Last author)DZNE*

2026
Springer Wien [u.a.]

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Please use a persistent id in citations: doi:10.1007/s00702-026-03266-1

Abstract: In addition to response fluctuations caused by the pharmacokinetics of dopamine replacement medication, temporal variation in the expression and severity of motor and non-motor symptoms, which is not or only partially attributable to the effects of the medication, are also common in Parkinson's disease (PD). The spectrum of transient changes of motor symptom expression unrelated to the classical ON-OFF fluctuations ranges from brief episodes of gait freezing or tremor breakthroughs to severe akinetic crisis and non-motor phenomena include discontinuous changes in cognition and vigilance. Disease-related factors such as dementia or orthostatic dysregulation or disturbances of the circadian rhythm may also contribute to these non-pharmacological symptom fluctuations. Additionally, external factors including infections or surgery and general anaesthesia can lead to transient changes of PD symptom severity and drug responsiveness. Accurately classifying these symptom oscillations and distinguishing them from drug-induced ON-OFF fluctuations is essential for their appropriate management.

Keyword(s): Humans (MeSH) ; Parkinson Disease: physiopathology (MeSH) ; Parkinson Disease: drug therapy (MeSH) ; Parkinson Disease: complications (MeSH) ; Parkinson Disease: diagnosis (MeSH) ; Antiparkinson Agents: therapeutic use (MeSH) ; Fluctuations ; Freezing ; Orthostatic dysregulation ; Parkinson's disease ; Symptom variations ; Antiparkinson Agents

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Contributing Institute(s):

1. Non-Motor Symptoms in Parkinson's disease (AG Storch)

Research Program(s):

1. 353 - Clinical and Health Care Research (POF4-353) (POF4-353)

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Database coverage:
; BIOSIS Previews ; Biological Abstracts ; Clarivate Analytics Master Journal List ; Current Contents - Life Sciences ; DEAL Springer ; DEAL Springer ; Ebsco Academic Search ; Essential Science Indicators ; IF < 5 ; JCR ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection

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