skip to main content

PD – On-Time Treatment Target — SCE Neurology MCQ

Instant feedback + full explanation. One question, done properly.

ModerateMovement DisordersPD – On-Time Treatment TargetSCE Neurology

A 60-year-old man with PD on levodopa for 8 years has developed motor fluctuations. His 'on' time is approximately 8 hours per day (out of 16 waking hours). His neurologist measures this using a patient diary. What is considered adequate 'on' time as a treatment target?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — The goal is to maximise 'on' time without troublesome dyskinesia ('good on' time) — typically aiming for ≥12 hours of good quality on-time per day; the patient diary (recording on/off states hourly) is the gold standard for documenting fluctuations

The treatment goal in fluctuating PD is to maximise 'good quality on-time' (time spent with adequate motor function without troublesome dyskinesia) and minimise off-time. Patient diaries (hourly recording of motor state: on, off, on with troublesome dyskinesia, on without troublesome dyskinesia, asleep) over 3–7 days provide objective data for treatment decisions. A target of ≥12–13 hours of good on-time per 16 waking hours is often used. The Hauser diary is the standard tool. A: Quality matters, not just quantity. C: The whole day matters. D: Diaries measure it effectively. E: Some off-time is often unavoidable in advanced PD.

Reference: NICE NG71; Hauser et al. Patient Diary; MDS Motor Fluctuation Assessment