Neuropsychiatric fluctuations in Parkinson’s disease: A French multicenter study of the NFS psychometric properties
Parkinsonism & Related Disorders. 2025-07-01; : 107954
DOI: 10.1016/j.parkreldis.2025.107954
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https://www.bordeaux-neurocampus.fr/11898
Schmitt E(1), Bouvard M(2), Anheim M(3), Guehl D(4), Klinger H(5), Laurencin
C(6), Marques A(7), Meissner WG(8), Thobois S(6), Thomas J(4), Tir M(9), Debu
B(10), Moro E(10); NFS-VALID Study.
Author information:
(1)Grenoble Alpes University, Division of Neurology, CHU of Grenoble, Grenoble
Institute of Neuroscience, INSERM, U1216, Grenoble, France. Electronic address:
.
(2)Psychology and Neurocognition Laboratory, Grenoble Alpes University, Savoie
Mont Blanc University, Grenoble, France.
(3)Strasbourg University Hospital, Department of Neurology, Parkinson Expert
Centre, U964/UMR7104 ; University of Strasbourg, INSERM, CNRS, Strasbourg,
France; Strasbourg Institute of Neuroscience, Strasbourg, France.
(4)CHU Bordeaux, Service de Neurologie des Maladies Neurodégénératives, IMNc,
F-33000, Bordeaux, France; University of Bordeaux, CNRS, IMN, UMR 5293, F-33000,
Bordeaux, France.
(5)Service des Pathologies du Mouvement, Hopital Neurologique Pierre Wertheimer,
Hospices Civils de Lyon, NS-PARK, Lyon, France.
(6)Service des Pathologies du Mouvement, Hopital Neurologique Pierre Wertheimer,
Hospices Civils de Lyon, NS-PARK, Lyon, France; University Lyon 1, Lyon
Neuroscience Research Center, INSERM U1028, CNRS UMR5292, PATH-PARK Team, Lyon,
France.
(7)Neurology Department, Université Clermont Auvergne, EA7280 NPsy-Sydo,
Clermont-Ferrand University Hospital, Clermont-Ferrand, France.
(8)CHU Bordeaux, Service de Neurologie des Maladies Neurodégénératives, IMNc,
F-33000, Bordeaux, France; University of Bordeaux, CNRS, IMN, UMR 5293, F-33000,
Bordeaux, France; Dept. Medicine, University of Otago, Christchurch, and New
Zealand Brain Research Institute, Christchurch, New Zealand.
(9)Department of Neurology and Movement Disorders, Amiens Picardie University
Hospital, France; Expert Center for Parkinson’s Disease, Amiens Picardie
University Hospital, Amiens, France.
(10)Grenoble Alpes University, Division of Neurology, CHU of Grenoble, Grenoble
Institute of Neuroscience, INSERM, U1216, Grenoble, France.
BACKGROUND: 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.
OBJECTIVE: To evaluate and confirm the psychometric characteristics of the NFS
in a prospective multicenter study (NFS-VALID).
METHOD: 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.
RESULTS: 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.
CONCLUSION: This study confirms that the NFS is a reliable tool to evaluate
NpsyF in PD patients in an acute setting.
Copyright © 2025 The Authors. Published by Elsevier Ltd.. All rights reserved.
DOI: 10.1016/j.parkreldis.2025.107954
PMID: 40683099
Conflict of interest statement: Declaration of competing interest The authors
declare the following financial interests/personal relationships which may be
considered as potential competing interests. Emmanuelle Schmitt has received
honoraria from Asten Santé for consulting services, and from Grenoble Alpes
University. Elena Moro has receid honoraria from Medtronic for consulting
service. Mathieu Anheim reports travel grants and/or honoraria from Merz, Orkyn,
AbbVie, Teva, Aguettant, Ever Pharma, Linde, Asdia, Reata Pharmaceuticals,
IPSEN, Biogen and grant from French Ministry of Health: PHRC grant. Outside the
present work, Wassilios G. Meissner has received consultancy fees from
Inhibikase, Koneksa and TreeFrog. Martine Bouvard, Melissa Tir, Juliette Thomas,
Ana Marques, Dominique Guehl, Helene Klinger, Chloe Laurencin, Bettina Debuand
Stephane Thobois did not report any conflicts of interest.