ABSTRACT
UNLABELLED: Akinetic symptoms or off-period motor signs in patients with Parkinson's disease and motor fluctuations can be associated with subjective symptoms. A systematic interview was conducted in a series of 24 patients. Sixteen out of 24 (67 p. cent) experienced these subjective symptoms as on-off non motor symptoms that were classified in three groups: energy lost consistent with a severe asthenia, perceptive and cognitive alterations, and emotional troubles such as panic and depression. These phenomenons could be combined in some patients and were sometimes asynchron to akinesia. In some patients (six cases reported), they occurred without any akinesia but could totally inhibit patients daily activities, and so could be described as subjective off-period . Frequently, the patients did not distinguish them from motor disability. Their persistence, after subthalamic nucleus stimulation or intrastriatal transplant, could interfere with functional results, even though akinetic symptoms had disappeared. CONCLUSION: subjective phenomenons during off-periods are frequent. Their frequency is underestimated due to a non-targeted examination. Subjective off-periods are symptoms of Parkinson's disease, partly independent from off motor symptoms, and important to consider in evaluation of therapeutics, especially surgery.
