Neuropsychiatric fluctuations in Parkinson's disease: A French multicenter study of the NFS psychometric properties

Neuropsychiatric fluctuations (NpsyF) are common in advanced Parkinson's disease patients (PD). In the OFF-medication condition, they manifest as minus symptoms such as anxiety and fatigue, while in the ON-medication condition, plus symptoms like euphoria appear. These fluctuations significantly impact the quality of life for patients and caregivers, making their identification crucial for effective PD management. The Neuropsychiatric Fluctuation Scale (NFS) was developed to assess NpsyF in real time, and a recent study indicated that the NFS has good psychometric properties.

To evaluate and confirm the psychometric characteristics of the NFS in a prospective multicenter study (NFS-VALID).

The NFS was administered to PD patients with motor fluctuations in both ON and OFF-medication conditions, alongside other assessment scales, including motor scale and evaluations of emotional and behavioral aspects. Internal structure was evaluated using principal component analysis (PCA), and internal consistency was assessed with Cronbach's alpha. External validity was measured through correlations with other scales. Specificity was assessed by comparing NFS scores between controls and PD patients, as well as between PD patients with and without NpsyF. Sensitivity was evaluated using t-tests comparing NFS in ON and OFF conditions.

128 PD patients and 131controls were included. PCA revealed two components with a main one explaining 35-42 % of the variance. Internal consistency was good (alpha >.85 in ON and OFF). The NFS showed good specificity and sensitivity.

This study confirms that the NFS is a reliable tool to evaluate NpsyF in PD patients in an acute setting.