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New Scale for Measuring Non-Motor Fluctuations in Parkinson’s Disease

The Movement Disorder Society (MDS) recently developed and validated a new scale for assessing non-motor fluctuations in Parkinson’s disease patients. The Non-Motor Fluctuations Assessment Questionnaire (NoMoFA) is a patient-reported outcome measure that seeks to characterize the non-motor symptoms that may fluctuate in parallel with motor symptoms.

Non-motor symptoms have a significant impact on the quality of life for patients with Parkinson’s disease. These symptoms are wide-ranging and can include cognitive symptoms, fatigue, pain, restlessness, urinary symptoms, vision changes, shortness of breath, and more. Recognition of these symptoms’ impact has been a key driver behind efforts to create valid assessments of non-motor symptoms. However, existing scales measuring non-motor symptoms either do not address fluctuations in those symptoms or only look at fluctuations as a subset. The NoMoFA is the first scale that directly and specifically assesses non-motor symptoms in the OFF state. Many patients are at least as bothered by these non-motor OFF symptoms as by motor OFF symptoms and are a likely target in developing future treatments.

MDS has published the results of a study validating the use of the NoMoFA to assess fluctuating non-motor symptoms in patients with Parkinson’s disease. The study included 180 English speaking subjects from the US and Canada with a clinical diagnosis of Parkinson’s disease and ranged from mild to severe cases. The NoMOFA makes it possible to conduct the studies needed to determine whether non-motor symptom fluctuations improve with intervention. This opens the door to trials that would support expanding some of the recently approved medications for motor fluctuations to include a new indication of non-motor fluctuations.

Learn more about VeraSci’s expertise in Parkinson’s disease.


Kleiner, G., Fernandez, H. H., Chou, K. L., Fasano, A., Duque, K. R., Hengartner, D., Law, A., Margolius, A., Poon, Y., Farret, M.S., Saleh, P. Vizcarra, J.A., Stebbins, G.T., Espay, A. J. (2021). Non‐Motor fluctuations in Parkinson’s Disease: Validation of the non‐motor Fluctuation Assessment Questionnaire. Movement Disorders. doi:10.1002/mds.28507