Correlation between the Movement Disorders Society Unified Parkinson’s Disease rating scale (MDS-UPDRS) and the Unified Parkinson’s Disease rating scale (UPDRS) during l-dopa acute challenge

Merello, Marcelo; Gerschcovich, Eliana Roldan; Ballesteros, Diego; Cerquetti, Daniel

doi:10.1016/j.parkreldis.2011.07.002

Cited by 42 publications

(51 citation statements)

References 8 publications

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“…Second, the LDCT is feasible in patients with de novo PD, which is important especially for clinical studies that rely on an early diagnosis. Third, when using the UPDRS III motor scale, we propose an improvement of one‐third (33%) of the total score as the best cutoff point for a positive versus negative test result, thereby confirming previous data reported by Merello et al According to a previous correlation study, this would be equivalent to a 24% change in the MDS‐UPDRS motor score . Sensitivity and specificity can be further improved if there is no involuntary loss of urine and no fainting in the recent past, if an asymmetric tremor is apparent, and if there is low drug intake.…”

Section: Discussionsupporting

confidence: 86%

“…A 30% minimum motor improvement compared with baseline has been considered clinically significant and thus was recommended in guidelines . For the newer, Movement Disorder Society‐sponsored revision of the UPDRS (MDS‐UPDRS), an equivalent 24% motor improvement was proposed for predicting sustained, long‐term l ‐dopa response, with a high correlation between the 2 scales …”

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confidence: 99%

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Acute Levodopa Challenge Test in Patients with de novo Parkinson's Disease: Data from the DeNoPa Cohort

Schade

Sixel‐Döring

Ebentheuer

et al. 2017

Movement Disord Clin Pract

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Background The precise clinical diagnosis of Parkinson's disease (PD) can be difficult in the early stages. Diagnostic criteria include the response of key motor features to levodopa as a supportive prospective criterion. Data are sparse on the diagnostic value of the acute levodopa challenge test (LDCT) in patients with de novo PD. The objective of this study was to validate the LDCT as a tool in the early clinical diagnosis of PD. Methods We performed the standardized LDCT with 250 mg levodopa in the prospective longitudinal cohort study “DeNoPa,” comprising 159 patients with de novo PD, and carried out longitudinal clinical follow‐up for 24 months. Motor assessments at baseline using the motor part (part III) of the Unified Parkinson's Disease Rating Scale before and 1 hr after drug administration were documented. The optimal cutoff score on the LDCT was calculated using the Youden index. Results Clinical reassessment of 144 patients who returned for follow‐up confirmed the diagnosis of PD in 120 patients (83%). In 24 patients (17%), the initial diagnoses were revised and classified as other neurologic disorders. The optimal cutoff at 33% improvement of motor symptoms on the part 3 of the Unified Parkinson's Disease Rating Scale during the LDCT reached a sensitivity of 70% a specificity of 71%. The positive and negative predictive values were 92% and 32%, respectively. Sensitivity (91%), specificity (79%), and positive/negative (96%/63%) predictive values improved with the addition of further clinical information (urinary incontinence, fainting, asymmetric tremor, and amount of further drug‐intake). Conclusions The LDCT is a reliable tool in the early diagnosis of PD. The accuracy of this test can be further improved by additional, easy‐to‐acquire clinical information provided by patients. © 2017 International Parkinson and Movement Disorder Society.

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Section: Discussionsupporting

confidence: 86%

mentioning

confidence: 99%

Acute Levodopa Challenge Test in Patients with de novo Parkinson's Disease: Data from the DeNoPa Cohort

Schade

Sixel‐Döring

Ebentheuer

et al. 2017

Movement Disord Clin Pract

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“…Evaluations of the two scales show extremely high correlations between the motor sections of the MDS-UPDRS and UPDRS [26, 27]. These findings could be a starting point for exploration of possible subscales within the MDS-UPDRS.…”

Section: Discussionmentioning

confidence: 96%

Confirmatory Factor Analysis of the Motor Unified Parkinson’s Disease Rating Scale

Vassar

Bordelon

Diaz

et al. 2012

Parkinson's Disease

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The motor examination section of the unified Parkinson's disease rating scale (UPDRS) is widely used in research but few studies have examined whether subscales exist that tap relatively distinct motor abnormalities. We analyzed data from 193 persons enrolled in a population-based study in Central California. Patients were examined after overnight PD medication washout (“OFF” state) and approximately one hour after taking medication (“ON” state). We performed confirmatory factor analysis of the UPDRS for OFF and ON state examinations; correlations, reliability, and relative validity of resulting subscales were evaluated. A model with five factors (gait/posture, tremor, rigidity, bradykinesia affecting the left extremities, bradykinesia affecting the right extremities) fit the data well, with similar results for OFF and ON states. Internal consistency reliability coefficients were 0.90 or higher for all subscales. The gait/posture subscale most strongly discriminated across levels of patient reported PD symptom severity and of how PD affects them on a daily basis. Compared to the right sided bradykinesia subscale, the left sided bradykinesia subscale had higher discrimination across levels of self-reported PD symptom severity and functional impairment. This supports motor UPDRS containing multiple subscales that can be analyzed separately and provide information distinct from the total score that may be useful in clinical studies.

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“…First, we recognize that with the recent development of the Movement Disorder Society-UPDRS (MDS-UPDRS), the standard UPDRS may eventually become obsolete. However, correlational studies have shown the motor UPDRS to have both excellent correlation (Pearson’s r = 0.97, p < 0.001) [12] and high internal consistency (Cronbach’s alpha = 0.90) [13] with the motor MDS-UPDRS, suggesting that reliability and validity of the mUPDRS in our study may be applicable to the MDS-UPDRS, but should be assessed in a separate trial using this scale. Also, while Cubo et al [14] has recently demonstrated that in home web-based assessments for assessing PD-related impairments is feasible, our study did not address feasibility.…”

Section: Discussionmentioning

confidence: 78%

Potential reliability and validity of a modified version of the Unified Parkinson's Disease Rating Scale that could be administered remotely

Abdolahi

Scoglio

Killoran

et al. 2013

Parkinsonism & Related Disorders

118

108

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Background By permitting remote assessments of patients and research participants, telemedicine has the potential to reshape clinical care and clinical trials for Parkinson disease. While the majority of the motor Unified Parkinson’s Disease Rating Scale (UPDRS) items can be conducted visually, rigidity and retropulsion pull testing require hands-on assessment by the rater and are less feasible to perform remotely in patients' homes. Methods In a secondary data analysis of the Comparison of the Agonist pramipexole vs. Levodopa on Motor complications in Parkinson’s Disease (CALM-PD) study, a randomized clinical trial, we assessed the cross-sectional (baseline and 2 years) and longitudinal (change from baseline to 2 years) reliability of a modified motor UPDRS (removing rigidity and retropulsion items) compared to the standard motor UPDRS (all items) using intraclass correlation coefficients (ICC), stratified by treatment group. Internal consistency of the modified UPDRS (mUPDRS) was measured using Cronbach’s alpha, and concurrent validity was assessed using Pearson’s correlation coefficient (r) between the standard motor UPDRS and mUPDRS. Results The mUPDRS versus standard motor UPDRS is cross-sectionally (ICC ≥ 0.92) and longitudinally (ICC ≥ 0.92) reliable for both treatment groups. High internal consistencies were also observed (α ≥ 0.96). The mUPDRS had high concurrent validity with the standard UPDRS at both time points and longitudinally (r ≥ 0.93, p < 0.0001). Conclusions A modified version of the motor UPDRS without rigidity and retropulsion pull testing is reliable and valid and may lay the foundation for its use in remote assessments of patients and research participants.

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Correlation between the Movement Disorders Society Unified Parkinson’s Disease rating scale (MDS-UPDRS) and the Unified Parkinson’s Disease rating scale (UPDRS) during l-dopa acute challenge

Cited by 42 publications

References 8 publications

Acute Levodopa Challenge Test in Patients with de novo Parkinson's Disease: Data from the DeNoPa Cohort

Acute Levodopa Challenge Test in Patients with de novo Parkinson's Disease: Data from the DeNoPa Cohort

Confirmatory Factor Analysis of the Motor Unified Parkinson’s Disease Rating Scale

Potential reliability and validity of a modified version of the Unified Parkinson's Disease Rating Scale that could be administered remotely

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