Development of a Non-Motor Fluctuation Assessment Instrument for Parkinson Disease
Identifieur interne : 000968 ( Pmc/Checkpoint ); précédent : 000967; suivant : 000969Development of a Non-Motor Fluctuation Assessment Instrument for Parkinson Disease
Auteurs : Galit Kleiner-Fisman [Canada] ; Rebecca Martine [États-Unis] ; Anthony E. Lang [Canada] ; Matthew B. SternSource :
- Parkinson's Disease [ 2090-8083 ] ; 2011.
Abstract
Patients with Parkinson disease are increasingly recognized to suffer from non-motor symptoms in addition to motor symptoms. Many non-motor symptoms fluctuate in parallel with motor symptoms and in relationship to plasma levodopa levels. Though these symptoms are troublesome and result in reduced quality of life to patients and their caregivers, there has not been an objective method of recognizing and quantifying non-motor fluctuations (NMFs). This study sought to develop a patient-based instrument that would accurately capture the experience of patients with NMFs. Patient-based nominal group technique sessions, focus groups, and expert opinion were utilized in developing this questionnaire.
Url:
DOI: 10.4061/2011/292719
PubMed: 21860778
PubMed Central: 3153935
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Development of a Non-Motor Fluctuation Assessment Instrument for Parkinson Disease</title><author><name sortKey="Kleiner Fisman, Galit" sort="Kleiner Fisman, Galit" uniqKey="Kleiner Fisman G" first="Galit" last="Kleiner-Fisman">Galit Kleiner-Fisman</name><affiliation wicri:level="4"><nlm:aff id="I1">Baycrest Hospital, University of Toronto, 3560 Bathurst Street, Toronto, ON, Canada M6A 2E1</nlm:aff><country>Canada</country><wicri:regionArea>Baycrest Hospital, University of Toronto, 3560 Bathurst Street, Toronto, ON</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Martine, Rebecca" sort="Martine, Rebecca" uniqKey="Martine R" first="Rebecca" last="Martine">Rebecca Martine</name><affiliation wicri:level="1"><nlm:aff id="I2">Parkinson's Disease Research Education and Clinical Center (PADRECC), Philadelphia VA Medical Center, Philadelphia, PA 19107, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Parkinson's Disease Research Education and Clinical Center (PADRECC), Philadelphia VA Medical Center, Philadelphia, PA 19107</wicri:regionArea><wicri:noRegion>PA 19107</wicri:noRegion></affiliation></author><author><name sortKey="Lang, Anthony E" sort="Lang, Anthony E" uniqKey="Lang A" first="Anthony E." last="Lang">Anthony E. Lang</name><affiliation wicri:level="4"><nlm:aff id="I3">Toronto Western Hospital, University of Toronto, Toronto, ON, Canada M5I 2S8</nlm:aff><country>Canada</country><wicri:regionArea>Toronto Western Hospital, University of Toronto, Toronto, ON</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Stern, Matthew B" sort="Stern, Matthew B" uniqKey="Stern M" first="Matthew B." last="Stern">Matthew B. Stern</name><affiliation><nlm:aff>NONE</nlm:aff></affiliation><affiliation><nlm:aff>NONE</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">21860778</idno><idno type="pmc">3153935</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3153935</idno><idno type="RBID">PMC:3153935</idno><idno type="doi">10.4061/2011/292719</idno><date when="2011">2011</date><idno type="wicri:Area/Pmc/Corpus">000B36</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000B36</idno><idno type="wicri:Area/Pmc/Curation">000B36</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000B36</idno><idno type="wicri:Area/Pmc/Checkpoint">000968</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000968</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Development of a Non-Motor Fluctuation Assessment Instrument for Parkinson Disease</title><author><name sortKey="Kleiner Fisman, Galit" sort="Kleiner Fisman, Galit" uniqKey="Kleiner Fisman G" first="Galit" last="Kleiner-Fisman">Galit Kleiner-Fisman</name><affiliation wicri:level="4"><nlm:aff id="I1">Baycrest Hospital, University of Toronto, 3560 Bathurst Street, Toronto, ON, Canada M6A 2E1</nlm:aff><country>Canada</country><wicri:regionArea>Baycrest Hospital, University of Toronto, 3560 Bathurst Street, Toronto, ON</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Martine, Rebecca" sort="Martine, Rebecca" uniqKey="Martine R" first="Rebecca" last="Martine">Rebecca Martine</name><affiliation wicri:level="1"><nlm:aff id="I2">Parkinson's Disease Research Education and Clinical Center (PADRECC), Philadelphia VA Medical Center, Philadelphia, PA 19107, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Parkinson's Disease Research Education and Clinical Center (PADRECC), Philadelphia VA Medical Center, Philadelphia, PA 19107</wicri:regionArea><wicri:noRegion>PA 19107</wicri:noRegion></affiliation></author><author><name sortKey="Lang, Anthony E" sort="Lang, Anthony E" uniqKey="Lang A" first="Anthony E." last="Lang">Anthony E. Lang</name><affiliation wicri:level="4"><nlm:aff id="I3">Toronto Western Hospital, University of Toronto, Toronto, ON, Canada M5I 2S8</nlm:aff><country>Canada</country><wicri:regionArea>Toronto Western Hospital, University of Toronto, Toronto, ON</wicri:regionArea><orgName type="university">Université de Toronto</orgName><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Stern, Matthew B" sort="Stern, Matthew B" uniqKey="Stern M" first="Matthew B." last="Stern">Matthew B. Stern</name><affiliation><nlm:aff>NONE</nlm:aff></affiliation><affiliation><nlm:aff>NONE</nlm:aff></affiliation></author></analytic><series><title level="j">Parkinson's Disease</title><idno type="ISSN">2090-8083</idno><idno type="eISSN">2042-0080</idno><imprint><date when="2011">2011</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>Patients with Parkinson disease are increasingly recognized to suffer from non-motor symptoms in addition to motor symptoms. Many non-motor symptoms fluctuate in parallel with motor symptoms and in relationship to plasma levodopa levels. Though these symptoms are troublesome and result in reduced quality of life to patients and their caregivers, there has not been an objective method of recognizing and quantifying non-motor fluctuations (NMFs). This study sought to develop a patient-based instrument that would accurately capture the experience of patients with NMFs. Patient-based nominal group technique sessions, focus groups, and expert opinion were utilized in developing this questionnaire.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Chaudhuri, Kr" uniqKey="Chaudhuri K">KR Chaudhuri</name></author><author><name sortKey="Healy, Dg" uniqKey="Healy D">DG Healy</name></author><author><name sortKey="Schapira, Ahv" uniqKey="Schapira A">AHV Schapira</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Chaudhuri, Kr" uniqKey="Chaudhuri K">KR Chaudhuri</name></author><author><name sortKey="Yates, L" uniqKey="Yates L">L Yates</name></author><author><name sortKey="Martinez Martin, P" uniqKey="Martinez Martin P">P Martinez-Martin</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hornykiewicz, O" uniqKey="Hornykiewicz O">O Hornykiewicz</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Widnell, K" uniqKey="Widnell K">K Widnell</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kukull, Wa" uniqKey="Kukull W">WA Kukull</name></author><author><name sortKey="Larson, Eb" uniqKey="Larson E">EB Larson</name></author><author><name sortKey="Teri, L" uniqKey="Teri L">L Teri</name></author><author><name sortKey="Bowen, J" uniqKey="Bowen J">J Bowen</name></author><author><name sortKey="Mccormick, W" uniqKey="Mccormick W">W McCormick</name></author><author><name sortKey="Pfanschmidt, Ml" uniqKey="Pfanschmidt M">ML Pfanschmidt</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Moore, C" uniqKey="Moore C">C Moore</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Miyasaki, Jm" uniqKey="Miyasaki J">JM Miyasaki</name></author><author><name sortKey="Shannon, K" uniqKey="Shannon K">K Shannon</name></author><author><name sortKey="Voon, V" uniqKey="Voon V">V Voon</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Stacy, M" uniqKey="Stacy M">M Stacy</name></author><author><name sortKey="Hauser, R" uniqKey="Hauser R">R Hauser</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Witjas, T" uniqKey="Witjas T">T Witjas</name></author><author><name sortKey="Kaphan, E" uniqKey="Kaphan E">E Kaphan</name></author><author><name sortKey="Azulay, Jp" uniqKey="Azulay J">JP Azulay</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Shulman, Lm" uniqKey="Shulman L">LM Shulman</name></author><author><name sortKey="Taback, Rl" uniqKey="Taback R">RL Taback</name></author><author><name sortKey="Rabinstein, Aa" uniqKey="Rabinstein A">AA Rabinstein</name></author><author><name sortKey="Weiner, Wj" uniqKey="Weiner W">WJ Weiner</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Goetz, Cg" uniqKey="Goetz C">CG Goetz</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Chaudhuri, Kr" uniqKey="Chaudhuri K">KR Chaudhuri</name></author><author><name sortKey="Martinez Martin, P" uniqKey="Martinez Martin P">P Martinez-Martin</name></author><author><name sortKey="Schapira, Ahv" uniqKey="Schapira A">AHV Schapira</name></author></analytic></biblStruct></listBibl></div1></back></TEI><pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Parkinsons Dis</journal-id><journal-id journal-id-type="publisher-id">PD</journal-id><journal-title-group><journal-title>Parkinson's Disease</journal-title></journal-title-group><issn pub-type="ppub">2090-8083</issn><issn pub-type="epub">2042-0080</issn><publisher><publisher-name>SAGE-Hindawi Access to Research</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">21860778</article-id><article-id pub-id-type="pmc">3153935</article-id><article-id pub-id-type="doi">10.4061/2011/292719</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group></article-categories><title-group><article-title>Development of a Non-Motor Fluctuation Assessment Instrument for Parkinson Disease</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Kleiner-Fisman</surname><given-names>Galit</given-names></name><xref ref-type="aff" rid="I1"><sup>1</sup></xref><xref ref-type="corresp" rid="cor1">*</xref></contrib><contrib contrib-type="author"><name><surname>Martine</surname><given-names>Rebecca</given-names></name><xref ref-type="aff" rid="I2"><sup>2</sup></xref></contrib><contrib contrib-type="author"><name><surname>Lang</surname><given-names>Anthony E.</given-names></name><xref ref-type="aff" rid="I3"><sup>3</sup></xref></contrib><contrib contrib-type="author"><name><surname>Stern</surname><given-names>Matthew B.</given-names></name><xref ref-type="aff" rid="I2"><sup>2, 4</sup></xref><xref ref-type="aff" rid="I4"></xref></contrib></contrib-group><aff id="I1"><sup>1</sup>Baycrest Hospital, University of Toronto, 3560 Bathurst Street, Toronto, ON, Canada M6A 2E1</aff><aff id="I2"><sup>2</sup>Parkinson's Disease Research Education and Clinical Center (PADRECC), Philadelphia VA Medical Center, Philadelphia, PA 19107, USA</aff><aff id="I3"><sup>3</sup>Toronto Western Hospital, University of Toronto, Toronto, ON, Canada M5I 2S8</aff><aff id="I4"><sup>4</sup>School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA</aff><author-notes><corresp id="cor1">*Galit Kleiner-Fisman: <email>gkleinerfisman@yahoo.com</email></corresp><fn fn-type="other"><p>Academic Editor: Alan R. Crossman</p></fn></author-notes><pub-date pub-type="collection"><year>2011</year></pub-date><pub-date pub-type="epub"><day>9</day><month>8</month><year>2011</year></pub-date><volume>2011</volume><elocation-id>292719</elocation-id><history><date date-type="received"><day>25</day><month>4</month><year>2011</year></date><date date-type="accepted"><day>24</day><month>5</month><year>2011</year></date></history><permissions><copyright-statement>Copyright © 2011 Galit Kleiner-Fisman et al.</copyright-statement><copyright-year>2011</copyright-year><license license-type="open-access"><license-p>This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p></license></permissions><abstract><p>Patients with Parkinson disease are increasingly recognized to suffer from non-motor symptoms in addition to motor symptoms. Many non-motor symptoms fluctuate in parallel with motor symptoms and in relationship to plasma levodopa levels. Though these symptoms are troublesome and result in reduced quality of life to patients and their caregivers, there has not been an objective method of recognizing and quantifying non-motor fluctuations (NMFs). This study sought to develop a patient-based instrument that would accurately capture the experience of patients with NMFs. Patient-based nominal group technique sessions, focus groups, and expert opinion were utilized in developing this questionnaire.</p></abstract></article-meta></front><floats-group><fig id="fig1" position="float"><label>Figure 1</label><caption><p>NMF questionnaire development schema. NGT: nominal group technique. *Focus group consisted of both new subjects and original members of the NGT sessions.</p></caption><graphic xlink:href="PD2011-292719.001"></graphic></fig><table-wrap id="tab1" position="float"><label>Table 1</label><caption><p>Characteristics of patient-participants.</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="1" colspan="1">Characteristics</th><th align="center" rowspan="1" colspan="1">Patients (<italic>n</italic> = 11)</th></tr></thead><tbody><tr><td align="left" rowspan="1" colspan="1">Mean age, years</td><td align="center" rowspan="1" colspan="1">74</td></tr><tr><td align="left" rowspan="1" colspan="1">Mean age onset of PD, years</td><td align="center" rowspan="1" colspan="1">64</td></tr><tr><td align="left" rowspan="1" colspan="1">Mean PD stage (H + Y), years</td><td align="center" rowspan="1" colspan="1">3</td></tr><tr><td align="left" rowspan="1" colspan="1">Mean LEDD, mg/d</td><td align="center" rowspan="1" colspan="1">770</td></tr><tr><td align="left" rowspan="1" colspan="1">Sex, % men</td><td align="center" rowspan="1" colspan="1">91</td></tr></tbody></table></table-wrap><table-wrap id="tab2" position="float"><label>Table 2</label><caption><p>Ranking of non-motor fluctuations (NMFs) symptoms by study participants*.</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="1" colspan="1">Rank</th><th align="center" rowspan="1" colspan="1">Symptom</th><th align="center" rowspan="1" colspan="1">Frequency<sup>¶</sup></th><th align="center" rowspan="1" colspan="1">Importance score*</th><th align="center" rowspan="1" colspan="1">Summary score<sup>†</sup></th></tr></thead><tbody><tr><td align="left" rowspan="1" colspan="1">1</td><td align="center" rowspan="1" colspan="1">Pain (OFF)</td><td align="center" rowspan="1" colspan="1">10</td><td align="center" rowspan="1" colspan="1">50</td><td align="center" rowspan="1" colspan="1">500</td></tr><tr><td align="left" rowspan="1" colspan="1">2</td><td align="center" rowspan="1" colspan="1">Confusion (OFF)</td><td align="center" rowspan="1" colspan="1">9</td><td align="center" rowspan="1" colspan="1">42</td><td align="center" rowspan="1" colspan="1">378</td></tr><tr><td align="left" rowspan="1" colspan="1">3</td><td align="center" rowspan="1" colspan="1">Poor concentration (OFF)</td><td align="center" rowspan="1" colspan="1">9</td><td align="center" rowspan="1" colspan="1">41</td><td align="center" rowspan="1" colspan="1">369</td></tr><tr><td align="left" rowspan="1" colspan="1">4</td><td align="center" rowspan="1" colspan="1">Frustration (OFF)</td><td align="center" rowspan="1" colspan="1">8</td><td align="center" rowspan="1" colspan="1">40</td><td align="center" rowspan="1" colspan="1">320</td></tr><tr><td align="left" rowspan="1" colspan="1">5</td><td align="center" rowspan="1" colspan="1">Urinary frequency (ON); urgency/incontinence (OFF)</td><td align="center" rowspan="1" colspan="1">7</td><td align="center" rowspan="1" colspan="1">33</td><td align="center" rowspan="1" colspan="1">231</td></tr><tr><td align="left" rowspan="1" colspan="1">6</td><td align="center" rowspan="1" colspan="1">Word-finding difficulty (OFF)</td><td align="center" rowspan="1" colspan="1">7</td><td align="center" rowspan="1" colspan="1">33</td><td align="center" rowspan="1" colspan="1">231</td></tr><tr><td align="left" rowspan="1" colspan="1">7</td><td align="center" rowspan="1" colspan="1">Word-finding difficulty (OFF)</td><td align="center" rowspan="1" colspan="1">7</td><td align="center" rowspan="1" colspan="1">25</td><td align="center" rowspan="1" colspan="1">175</td></tr><tr><td align="left" rowspan="1" colspan="1">8</td><td align="center" rowspan="1" colspan="1">Drooling (OFF)</td><td align="center" rowspan="1" colspan="1">6</td><td align="center" rowspan="1" colspan="1">23</td><td align="center" rowspan="1" colspan="1">138</td></tr><tr><td align="left" rowspan="1" colspan="1">9</td><td align="center" rowspan="1" colspan="1">Poor short-term memory (OFF)</td><td align="center" rowspan="1" colspan="1">5</td><td align="center" rowspan="1" colspan="1">25</td><td align="center" rowspan="1" colspan="1">125</td></tr><tr><td align="left" rowspan="1" colspan="1">10</td><td align="center" rowspan="1" colspan="1">Obsessive/compulsive behavior (OFF)</td><td align="center" rowspan="1" colspan="1">6</td><td align="center" rowspan="1" colspan="1">20</td><td align="center" rowspan="1" colspan="1">120</td></tr><tr><td align="left" rowspan="1" colspan="1">11</td><td align="center" rowspan="1" colspan="1">Poor judgment (OFF)</td><td align="center" rowspan="1" colspan="1">5</td><td align="center" rowspan="1" colspan="1">15</td><td align="center" rowspan="1" colspan="1">75</td></tr><tr><td align="left" rowspan="1" colspan="1">12</td><td align="center" rowspan="1" colspan="1">Depression (OFF)</td><td align="center" rowspan="1" colspan="1">5</td><td align="center" rowspan="1" colspan="1">14</td><td align="center" rowspan="1" colspan="1">70</td></tr><tr><td align="left" rowspan="1" colspan="1">13</td><td align="center" rowspan="1" colspan="1">Mood swings/emotional lability/irritability (OFF)</td><td align="center" rowspan="1" colspan="1">5</td><td align="center" rowspan="1" colspan="1">12</td><td align="center" rowspan="1" colspan="1">60</td></tr><tr><td align="left" rowspan="1" colspan="1">14</td><td align="center" rowspan="1" colspan="1">Insomnia (ON, OFF)</td><td align="center" rowspan="1" colspan="1">3</td><td align="center" rowspan="1" colspan="1">14</td><td align="center" rowspan="1" colspan="1">42</td></tr><tr><td align="left" rowspan="1" colspan="1">15</td><td align="center" rowspan="1" colspan="1">Agitation/irritability/impatience (OFF)</td><td align="center" rowspan="1" colspan="1">3</td><td align="center" rowspan="1" colspan="1">10</td><td align="center" rowspan="1" colspan="1">30</td></tr><tr><td align="left" rowspan="1" colspan="1">16</td><td align="center" rowspan="1" colspan="1">Lack of interest (OFF)</td><td align="center" rowspan="1" colspan="1">3</td><td align="center" rowspan="1" colspan="1">9</td><td align="center" rowspan="1" colspan="1">27</td></tr><tr><td align="left" rowspan="1" colspan="1">17</td><td align="center" rowspan="1" colspan="1">Decreased laughter (apathy?) (OFF)</td><td align="center" rowspan="1" colspan="1">2</td><td align="center" rowspan="1" colspan="1">12</td><td align="center" rowspan="1" colspan="1">24</td></tr><tr><td align="left" rowspan="1" colspan="1">18</td><td align="center" rowspan="1" colspan="1">Difficulty breathing (OFF)</td><td align="center" rowspan="1" colspan="1">2</td><td align="center" rowspan="1" colspan="1">11</td><td align="center" rowspan="1" colspan="1">22</td></tr><tr><td align="left" rowspan="1" colspan="1">19</td><td align="center" rowspan="1" colspan="1">Fatigue (OFF)</td><td align="center" rowspan="1" colspan="1">3</td><td align="center" rowspan="1" colspan="1">7</td><td align="center" rowspan="1" colspan="1">21</td></tr><tr><td align="left" rowspan="1" colspan="1">20</td><td align="center" rowspan="1" colspan="1">Hallucinations (OFF)</td><td align="center" rowspan="1" colspan="1">2</td><td align="center" rowspan="1" colspan="1">10</td><td align="center" rowspan="1" colspan="1">20</td></tr><tr><td align="left" rowspan="1" colspan="1">21</td><td align="center" rowspan="1" colspan="1">Increased perspiration/odor (ON)</td><td align="center" rowspan="1" colspan="1">2</td><td align="center" rowspan="1" colspan="1">7</td><td align="center" rowspan="1" colspan="1">14</td></tr><tr><td align="left" rowspan="1" colspan="1">22</td><td align="center" rowspan="1" colspan="1">Paranoia (OFF)</td><td align="center" rowspan="1" colspan="1">2</td><td align="center" rowspan="1" colspan="1">6</td><td align="center" rowspan="1" colspan="1">12</td></tr><tr><td align="left" rowspan="1" colspan="1">23</td><td align="center" rowspan="1" colspan="1">Double/blurry vision (OFF)</td><td align="center" rowspan="1" colspan="1">2</td><td align="center" rowspan="1" colspan="1">5</td><td align="center" rowspan="1" colspan="1">10</td></tr><tr><td align="left" rowspan="1" colspan="1">24</td><td align="center" rowspan="1" colspan="1">Decreased communication/social withdrawal (OFF)</td><td align="center" rowspan="1" colspan="1">1</td><td align="center" rowspan="1" colspan="1">7</td><td align="center" rowspan="1" colspan="1">7</td></tr><tr><td align="left" rowspan="1" colspan="1">25</td><td align="center" rowspan="1" colspan="1">Decreased reading comprehension (OFF)</td><td align="center" rowspan="1" colspan="1">1</td><td align="center" rowspan="1" colspan="1">6</td><td align="center" rowspan="1" colspan="1">6</td></tr><tr><td align="left" rowspan="1" colspan="1">26</td><td align="center" rowspan="1" colspan="1">Reduced coping skills (OFF)</td><td align="center" rowspan="1" colspan="1">1</td><td align="center" rowspan="1" colspan="1">6</td><td align="center" rowspan="1" colspan="1">6</td></tr><tr><td align="left" rowspan="1" colspan="1">27</td><td align="center" rowspan="1" colspan="1">Reduced sense of taste (OFF)</td><td align="center" rowspan="1" colspan="1">1</td><td align="center" rowspan="1" colspan="1">5</td><td align="center" rowspan="1" colspan="1">5</td></tr><tr><td align="left" rowspan="1" colspan="1">28</td><td align="center" rowspan="1" colspan="1">Tingling (OFF)</td><td align="center" rowspan="1" colspan="1">1</td><td align="center" rowspan="1" colspan="1">5</td><td align="center" rowspan="1" colspan="1">5</td></tr><tr><td align="left" rowspan="1" colspan="1">29</td><td align="center" rowspan="1" colspan="1">Constipation (ON)</td><td align="center" rowspan="1" colspan="1">1</td><td align="center" rowspan="1" colspan="1">5</td><td align="center" rowspan="1" colspan="1">5</td></tr><tr><td align="left" rowspan="1" colspan="1">30</td><td align="center" rowspan="1" colspan="1">Change in hearing (OFF)</td><td align="center" rowspan="1" colspan="1">1</td><td align="center" rowspan="1" colspan="1">3</td><td align="center" rowspan="1" colspan="1">3</td></tr><tr><td align="left" rowspan="1" colspan="1">31</td><td align="center" rowspan="1" colspan="1">Intermittently sleepy (OFF)</td><td align="center" rowspan="1" colspan="1">1</td><td align="center" rowspan="1" colspan="1">3</td><td align="center" rowspan="1" colspan="1">3</td></tr><tr><td align="left" rowspan="1" colspan="1">32</td><td align="center" rowspan="1" colspan="1">Numbness (OFF)<sup>‡</sup></td><td align="center" rowspan="1" colspan="1">0</td><td align="center" rowspan="1" colspan="1">0</td><td align="center" rowspan="1" colspan="1">0</td></tr><tr><td align="left" rowspan="1" colspan="1">33</td><td align="center" rowspan="1" colspan="1">Restlessness (ON)</td><td align="center" rowspan="1" colspan="1">0</td><td align="center" rowspan="1" colspan="1">0</td><td align="center" rowspan="1" colspan="1">0</td></tr></tbody></table><table-wrap-foot><fn><p>*Summation of individual scores. </p></fn><fn><p><sup>†</sup>Summary score: frequency X score. </p></fn><fn><p><sup>‡</sup>Mentioned as symptom but not ranked in top 7. </p></fn><fn><p><sup>¶</sup>Frequency: number of subjects ranking symptom. </p></fn><fn><p>19 participants asked to rank symptoms from 1–7 (least to most important). </p></fn><fn><p>133 total possible. </p></fn><fn><p>121/133—some subjects did not rank all 7.</p></fn></table-wrap-foot></table-wrap></floats-group></pmc><affiliations><list><country><li>Canada</li><li>États-Unis</li></country><region><li>Ontario</li></region><settlement><li>Toronto</li></settlement><orgName><li>Université de Toronto</li></orgName></list><tree><noCountry><name sortKey="Stern, Matthew B" sort="Stern, Matthew B" uniqKey="Stern M" first="Matthew B." last="Stern">Matthew B. Stern</name></noCountry><country name="Canada"><region name="Ontario"><name sortKey="Kleiner Fisman, Galit" sort="Kleiner Fisman, Galit" uniqKey="Kleiner Fisman G" first="Galit" last="Kleiner-Fisman">Galit Kleiner-Fisman</name></region><name sortKey="Lang, Anthony E" sort="Lang, Anthony E" uniqKey="Lang A" first="Anthony E." last="Lang">Anthony E. Lang</name></country><country name="États-Unis"><noRegion><name sortKey="Martine, Rebecca" sort="Martine, Rebecca" uniqKey="Martine R" first="Rebecca" last="Martine">Rebecca Martine</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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