Frequency and types of motor fluctuations in patients presenting with advanced Parkinson’s disease

Abstract

Objective: To determine the frequency and types of motor fluctuations in patients presenting with advanced Parkinson’s disease at a tertiary care hospital in Pakistan.

Methodology: This descriptive cross-sectional study was conducted at the Department of Neurology, Dr. Ruth K.M Pfau Civil Hospital, Karachi, from 1st June 2025 to 30th November 2025. A total of one hundred patients aged 25-75 years with advanced Parkinson’s disease were enrolled through consecutive non-probability sampling. Demographic, clinical, and disease-related variables were documented, motor fluctuations were systematically assessed using clinical impression of severity index for Parkinson disease (CISI-PD), and data were analyzed in SPSS v26 with Chi-square tests (p ≤ 0.05).

Results: In this cohort of one hundred advanced Parkinson’s disease patients, the mean age was 49.9 years (±15.6), with a mean BMI of 27.5 (±8.7) and average disease duration of 7.2 years (±11.9). The sample included 51% men and 49% women. Motor fluctuations were reported in 42%, predominantly wearing off (28.6%) and dyskinesia (26.2%). No demographic, clinical, or treatment factor showed significant association (p>0.05), though smokers exhibited a higher frequency (51.2% vs.35.1%, p = 0.080).

Conclusion: Wearing-off episodes and dyskinesia were the most common fluctuations in this study.