Scales for assessing nonmotor symptom severity changes in Parkinson's disease patients with symptom fluctuations

The impact of non-motor symptoms on quality of life may outweigh the effect of motor disturbances in Parkinson’s disease, and in advanced Parkinson’s disease patients may experience severe changes in fluctuating non-motor symptoms. In this review, the authors summarize available non-motor symptom assessments in patients with fluctuating symptoms, focusing specifically on scales that utilize a daily-diary format. Whilst several appropriate scales were identified, no single scale had all the desired characteristics, although several, including the Scales for Outcomes in Parkinson’s Disease (SCOPA), the Non-motor Symptoms Scale (NMSS) and Movement Disorder Society-sponsored revision of the Unified Parkinson’s Disease ratins Scale (MDS-UPDRS) Part 1 were eminently valid, practical and reliable. However, the development of a scale that provides a comprehensive assessment of non-motor symptoms in patients with symptom fluctuations is clearly required to aid clinical management and help improve quality of life.