Evaluation of severity of predominantly non-dopaminergic symptoms in Parkinson's disease: The SENS-PD scale

Heeden, Jorine F. van der; Marinus, Johan; Martinez‐Martín, Pablo; Hilten, Jacobus J. van

doi:10.1016/j.parkreldis.2016.02.016

Cited by 16 publications

(15 citation statements)

References 27 publications

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“…38,39 The SENS-PD scale addresses clinical features that mostly do not improve on dopaminergic treatment. 16 It is likely that these predominantly nondopaminergic items more accurately reflect the severity and progression of the underlying disease pathobiology. 1 We used CART analysis 20 -a machine-learning methodology using recursive partitioning-to classify patients on the basis of clinical and bioenergetic measures.…”

Section: Discussionmentioning

confidence: 99%

“…1 These 6 domains represent a coherent complex of symptoms that largely do not improve with dopaminergic medication that is already present in the early disease stages and increases in severity when the disease advances. 16 Higher scores on both scales reflect more severe impairment. Cognitive performance was assessed using the Scales for Outcomes in Parkinson's Disease-Cognition (range 0-43), a valid and reliable instrument examining the following domains: memory, attention, executive functioning, and visuospatial functioning 17 ; lower scores reflect more severe impairment.…”

Section: Patientsmentioning

confidence: 99%

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Peripheral mitochondrial function correlates with clinical severity in idiopathic Parkinson's disease

et al. 2019

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Background Parkinson's disease is an intractable disorder with heterogeneous clinical presentation that may reflect different underlying pathogenic mechanisms. Surrogate indicators of pathogenic processes correlating with clinical measures may assist in better patient stratification. Mitochondrial function, which is impaired in and central to PD pathogenesis, may represent one such surrogate indicator. Methods Mitochondrial function was assessed by respirometry experiment in fibroblasts derived from idiopathic patients (n = 47) in normal conditions and in experimental settings that do not permit glycolysis and therefore force energy production through mitochondrial function. Respiratory parameters and clinical measures were correlated with bivariate analysis. Machine‐learning‐based classification and regression trees were used to classify patients on the basis of biochemical and clinical measures. The effects of mitochondrial respiration on α‐synuclein stress were assessed monitoring the protein phosphorylation in permitting versus restrictive glycolysis conditions. Results Bioenergetic properties in peripheral fibroblasts correlate with clinical measures in idiopathic patients, and the correlation is stronger with predominantly nondopaminergic signs. Bioenergetic analysis under metabolic stress, in which energy is produced solely by mitochondria, shows that patients’ fibroblasts can augment respiration, therefore indicating that mitochondrial defects are reversible. Forcing energy production through mitochondria, however, favors α‐synuclein stress in different cellular experimental systems. Machine‐learning‐based classification identified different groups of patients in which increasing disease severity parallels higher mitochondrial respiration. Conclusion The suppression of mitochondrial activity in PD may be an adaptive strategy to cope with concomitant pathogenic factors. Moreover, mitochondrial measures in fibroblasts are potential peripheral biomarkers to follow disease progression. © 2019 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.

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Section: Discussionmentioning

confidence: 99%

Section: Patientsmentioning

confidence: 99%

Peripheral mitochondrial function correlates with clinical severity in idiopathic Parkinson's disease

et al. 2019

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“…The MDS-UPDRS motor scale (part III) was used to quantify the severity of motor symptoms (Goetz et al, 2008). The SENS-PD (SEverity of Non-dopaminergic Symptoms in Parkinson's Disease) scale is a composite score comprising three items with four response options (0–3) from each of the following six predominantly non-dopaminergic domains: postural instability and gait difficulty, psychotic symptoms, excessive daytime sleepiness, autonomic dysfunction, cognitive impairment and depressive symptoms (total range: 0–54) (Van der Heeden et al, 2014, Van der Heeden et al, 2016). These six domains represent a coherent complex of symptoms that is already present in the early disease stages and increases in severity when the disease advances.…”

Section: Methodsmentioning

confidence: 99%

“…Increasing evidence points at the existence of a coherent grouping of some of the clinical domains, which largely involve symptoms that do not improve on dopaminergic medication. The grouping of these symptoms is present early in the disease course (Van der Heeden et al, 2016), worsens over time (Van der Heeden et al, 2016), and probably reflects advancing Lewy body pathology in the nervous system (Adler and Beach, 2016). …”

Section: Introductionmentioning

confidence: 99%

Loss of integrity and atrophy in cingulate structural covariance networks in Parkinson's disease

Schipper

Marinus

Henselmans

et al. 2017

NeuroImage: Clinical

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BackgroundIn Parkinson's disease (PD), the relation between cortical brain atrophy on MRI and clinical progression is not straightforward. Determination of changes in structural covariance networks - patterns of covariance in grey matter density - has shown to be a valuable technique to detect subtle grey matter variations. We evaluated how structural network integrity in PD is related to clinical data.Methods3 Tesla MRI was performed in 159 PD patients. We used nine standardized structural covariance networks identified in 370 healthy subjects as a template in the analysis of the PD data. Clinical assessment comprised motor features (Movement Disorder Society-Unified Parkinson's Disease Rating Scale; MDS-UPDRS motor scale) and predominantly non-dopaminergic features (SEverity of Non-dopaminergic Symptoms in Parkinson's Disease; SENS-PD scale: postural instability and gait difficulty, psychotic symptoms, excessive daytime sleepiness, autonomic dysfunction, cognitive impairment and depressive symptoms). Voxel-based analyses were performed within networks significantly associated with PD.ResultsThe anterior and posterior cingulate network showed decreased integrity, associated with the SENS-PD score, p = 0.001 (β = − 0.265, ηp2 = 0.070) and p = 0.001 (β = − 0.264, ηp2 = 0.074), respectively. Of the components of the SENS-PD score, cognitive impairment and excessive daytime sleepiness were associated with atrophy within both networks.ConclusionsWe identified loss of integrity and atrophy in the anterior and posterior cingulate networks in PD patients. Abnormalities of both networks were associated with predominantly non-dopaminergic features, specifically cognition and excessive daytime sleepiness. Our findings suggest that (components of) the cingulate networks display a specific vulnerability to the pathobiology of PD and may operate as interfaces between networks involved in cognition and alertness.

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“…preoperative Med-ON vs. Med-OFF, and postoperative Med-ON/Stim-ON vs. Med-OFF/Stim-OFF) was used to reflect treatment benefit. The SEverity of predominantly Nondopaminergic Symptoms in PD (SENS-PD) scale [7] was used to assess nondopaminergic disease severity during Stim-ON/ Med-ON. The SENS-PD scale is a composite score comprising six predominantly non-dopaminergic domains: postural instability and gait difficulty (PIGD), psychotic symptoms, excessive daytime sleepiness, autonomic dysfunction, cognitive impairment, and depressive symptoms.…”

Section: Outcome Measuresmentioning

confidence: 99%

Stimulation challenge test after STN DBS improves satisfaction in Parkinson's disease patients

Geraedts

Hilten

Marinus

et al. 2019

Parkinsonism & Related Disorders

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Objective: Although subthalamic Deep Brain Stimulation (STN DBS) is proven effective in improving symptoms of Parkinson's Disease (PD), previous literature demonstrates a discrepancy between objective improvement and patients' perception thereof. We aimed to examine whether postoperative stimulation challenge tests (SCT) alters patients' satisfaction after STN DBS for PD. Methods: Fifty-four PD patients underwent preoperative levodopa challenge tests and were routinely invited for SCT 1-2 years postoperatively. SEverity of predominantly Nondopaminergic Symptoms in PD (SENS-PD) scores quantified non-dopaminergic disease severity. Motor functioning was quantified using Movement Disorders Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS) III scores; a ratio between conditions ON and OFF (preoperative Med-ON vs. Med-OFF, and postoperative Med-ON/Stim-ON vs. Med-OFF/Stim-OFF) reflected treatment benefit. 'Global Impression of Change' (GIC) and 'Global Satisfaction with Surgery' (GSS) Likert scales were filled out before and immediately after SCT. Results: Postoperative Med-ON/Stim-ON severity was lower than preoperative ON severity. Disease severity scores were not different between assessments. GIC and GSS scores were higher after SCT versus before (GIC: Z = -3.80, r = 0.37, subjects indicating maximum scores before SCT: 32.1%, after SCT: 57.1%; GSS: Z = -3.69, r = 0.35, maximum scores before SCT: 25.0%, after SCT: 46.4%). Higher non-dopaminergic disease severity was associated with lower GIC and GSS scores (GIC: OR 1.2 (95%CI 1.0-1.3); GSS: OR 1.2 (95%CI 1.1-1.3), while motor-scores and magnitude of DBS-effects were not. Conclusion: SCT improves patients' satisfaction and is recommended especially in case of suboptimal subjective valuations. This information should be considered in clinical practice and in the context of clinical trials.

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Evaluation of severity of predominantly non-dopaminergic symptoms in Parkinson's disease: The SENS-PD scale

Cited by 16 publications

References 27 publications

Peripheral mitochondrial function correlates with clinical severity in idiopathic Parkinson's disease

Peripheral mitochondrial function correlates with clinical severity in idiopathic Parkinson's disease

Loss of integrity and atrophy in cingulate structural covariance networks in Parkinson's disease

Stimulation challenge test after STN DBS improves satisfaction in Parkinson's disease patients

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