The wearing-off phenomenon and the use of questionnaires to facilitate its recognition in Parkinson’s disease
Abstract
Long-term treatment of Parkinson's disease (PD) with dopaminergic therapy is associated with a re-emergence of PD symptoms, referred to as wearing-off. Signs of wearing-off encompass motor symptoms, such as slowness of movement and stiffness, and non-motor symptoms, including anxiety and fatigue. Both motor and non-motor symptoms impact significantly on the function and quality of life of PD patients. Early detection and management of wearing-off has been shown to improve patient symptoms; however, identification of wearing-off, particularly the non-motor symptoms, is hampered by a lack of patient education, awareness, patient-physician communication, and limited time for evaluation. Several questionnaires have been developed to aid the detection of wearing-off. This review investigates the development and use of the Wearing-Off Questionnaires (WOQ-32, WOQ-19, and WOQ-9), as well as their sensitivity and specificity in identifying wearing-off. The manuscript also provides an overview of the motor and non-motor signs of wearing-off and highlights the available treatment strategies for managing this potentially debilitating phenomenon.
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Wearing-off in Parkinson's disease typically occurs prior to the next scheduled dose of dopaminergic therapy taking effect.
“This typically occurs prior to the next scheduled dose of dopaminergic therapy taking effect [4]”
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- Authors
- Stacy, M.
- Affiliations
- Duke University (US)
- Corresponding author
- Stacy, Mark
- Venue
- Journal of Neural Transmission
- Published
- 2010-06-20
- Volume
- 117
- Issue
- 7
- Pages
- 837-846
- ISSN
- 0300-9564 (ISSN-L)
- 1435-1463
- OpenAlex
- W2080453454
- Cited by
- 66
- References
- 53
- Citations by year
- 2026: 4 · 2025: 5 · 2024: 3 · 2023: 9 · 2022: 3 · 2021: 4 · 2020: 8 · 2018: 5 · 2017: 2 · 2016: 1 · 2015: 4 · 2014: 7 · 2013: 5 · 2012: 3
- FWCI
- 0.45
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Journal of Neural Transmission (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Neurology › Parkinson's Disease Mechanisms and Treatments
- Health Sciences › Medicine › Neurology › Neurological disorders and treatments
- Health Sciences › Medicine › Physiology › Voice and Speech Disorders
- Keywords
- wearing-off phenomenon, Parkinson's disease, dopaminergic therapy, non-motor symptoms, motor symptoms, early detection, questionnaire sensitivity and specificity, treatment options
- MeSH terms
- Antiparkinson Agents, Drug Tolerance, Humans, Parkinson Disease, Surveys and Questionnaires, Dopamine Agents
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