Movement Disorder Society‐sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS‐UPDRS): Scale presentation and clinimetric testing results

Goetz, Christopher G.; Tilley, Barbara C.; Shaftman, Stephanie R.; Stebbins, Glenn T.; Fahn, Stanley; Martinez‐Martín, Pablo; Poewe, Werner; Sampaio, Cristina; Stern, Matthew B.; Dodel, Richard; Dubois, Bruno; Holloway, Robert G.; Jankovic, Joseph; Kulisevsky, Jaime; Lang, Anthony E.; Lees, Andrew J.; Leurgans, Sue E.; LeWitt, Peter A.; Nyenhuis, David L.; Olanow, C. Warren; Rascol, Olivier; Schrag, Anette; Teresi, Jeanne A.; Hilten, Jacobus J. van; LaPelle, Nancy R.

doi:10.1002/mds.22340

Cited by 5,309 publications

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“…Clinical assessments included Movement Disorders Society‐Unified Parkinson Disease Rating Scale (MDS‐UPDRS) and Hoehn and Yahr scales 5. Global cognition was assessed with the MoCA 6, 7.…”

Section: Methodsmentioning

confidence: 99%

The Parkinson's progression markers initiative (PPMI) – establishing a PD biomarker cohort

Marek

Chowdhury

Siderowf

et al. 2018

Ann Clin Transl Neurol

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ObjectiveThe Parkinson's Progression Markers Initiative (PPMI) is an observational, international study designed to establish biomarker‐defined cohorts and identify clinical, imaging, genetic, and biospecimen Parkinson's disease (PD) progression markers to accelerate disease‐modifying therapeutic trials.MethodsA total of 423 untreated PD, 196 Healthy Control (HC) and 64 SWEDD (scans without evidence of dopaminergic deficit) subjects were enrolled at 24 sites. To enroll PD subjects as early as possible following diagnosis, subjects were eligible with only asymmetric bradykinesia or tremor plus a dopamine transporter (DAT) binding deficit on SPECT imaging. Acquisition of data was standardized as detailed at www.ppmi-info.org.ResultsApproximately 9% of enrolled subjects had a single PD sign at baseline. DAT imaging excluded 16% of potential PD subjects with SWEDD. The total MDS‐UPDRS for PD was 32.4 compared to 4.6 for HC and 28.2 for SWEDD. On average, PD subjects demonstrated 45% and 68% reduction in mean striatal and contralateral putamen Specific Binding Ratios (SBR), respectively. Cerebrospinal fluid (CSF) was acquired from >97% of all subjects. CSF (PD/HC/SWEDD pg/mL) α‐synuclein (1845/2204/2141) was reduced in PD vs HC or SWEDD (P < 0.03). Similarly, t‐tau (45/53) and p‐tau (16/18) were reduced in PD versus HC (P < 0.01),Interpretation PPMI has detailed the biomarker signature for an early PD cohort defined by clinical features and imaging biomarkers. This strategy provides the framework to establish biomarker cohorts and to define longitudinal progression biomarkers to support future PD treatment trials.

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Section: Methodsmentioning

confidence: 99%

The Parkinson's progression markers initiative (PPMI) – establishing a PD biomarker cohort

Marek

Chowdhury

Siderowf

et al. 2018

Ann Clin Transl Neurol

Self Cite

397

339

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“…Inclusion criteria were a diagnosis of PD according to the Brain Bank Criteria as assessed by a specialist for neurology, optimized and stable antiparkinsonian medication, and current PD motor symptoms expressed by a rating above 10 points on the Movement Disorder Society‐sponsored revision of the Unified Parkinson's Disease Rating Scale ( MDS‐UPDRS ) (Goetz et al., 2008) part III.…”

Section: Methodsmentioning

confidence: 99%

Relationships between activity and well‐being in people with parkinson's disease

et al. 2018

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ObjectivesThe complex symptomatology of Parkinson’ disease (PD) usually goes along with reduced physical activity. Previous studies have indicated positive effects of activating therapies on patients’ well‐being. This study, therefore, examined how activity in daily life is related to patients’ subjective condition.Materials and MethodsTwenty‐one PD patients rated their condition every two hours during two routine days and documented the duration and type of their activities (based on the PRISCUS‐Physical Activity Questionnaire) during the respective time intervals. They were furthermore assessed regarding motor and nonmotor symptoms, personality factors, and coping strategies.ResultsPatients spent on average 8.59 ± 2.93 hr per day at physical rest and 5.47 ± 2.93 hr physically active. We found highly significant associations between positive condition ratings (such as happiness, motivation, and concentration) and the duration of subsequent physical activities (adj.r 2 = .689) as well as between the duration of these activities and a subsequent improvement in the subjective condition (adj.r 2 = .545). This was strongest in patients using active coping strategies and showing agreeable and conscientious personality traits (adj.r 2 = .380). Nonmotor symptom severity was weakly inversely related to the daily amount of activities (adj.r 2 = .273), whereas no significant association with motor symptom severity was found.ConclusionsThe results suggest a feedback process between a positive subjective condition and physical activities in PD patients. This appears to depend on the use of active coping strategies and nonmotor symptoms rather than on motor symptom severity. The results should encourage physicians to address the importance of everyday physical activities and to provide patients with behavioral advice.

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“…Total levodopa equivalent daily dose (LEDD) was calculated using the standardized conversion formula (Tomlinson et al., 2010). The data on the prevalence of motor complications was obtained from two sources: patient cards and Part IV of the MDS‐UPDRS (Goetz et al., 2008). Patient cards were provided with binary questions assessing motor fluctuations, dyskinesias, and off‐dystonia that had occurred at any time during the disease.…”

Section: Methodsmentioning

confidence: 99%

Factors associated with motor complications in Parkinson's disease

et al. 2017

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ObjectivesLevodopa is the most effective therapy for treating Parkinson's disease (PD); however, side effects such as dyskinesias and motor fluctuations may occur after some years of its usage. The aims of this study were to assess the frequency of and factors associated with motor complications among PD patients on levodopa treatment.MethodsIn a cross‐sectional study carried out in 2010–2013, clinical data and treatment details were collected. Logistic regression expressed by odd ratios (OR) and 95% confidence intervals (CI) was conducted to examine the effects of several independent variables on the occurrence of motor complications.ResultsA total of 455 patients were enrolled, among whom 374 were on levodopa. Analysis was performed in 328 patients whose exact duration of levodopa treatment was known. Among patients included in the analysis, 25.9% experienced motor complications; of these, 21% had dyskinesias and 20.1% had motor fluctuations. Based on logistic regression, statistically significant factors associated with the occurrence of motor complications were younger age at onset of the disease, higher levodopa equivalent daily dose (LEDD), shorter time to levodopa initiation, and akinetic‐rigid dominant phenotype of PD.ConclusionsThis study suggests that postponing the start of levodopa therapy and maintaining low daily doses of levodopa might reduce the risk of motor complications. Our results confirm that due to higher risk of motor complications, effectively treating patients with akinetic‐rigid dominant phenotype of PD might be more challenging than for patients whose dominant symptom is tremor.

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Movement Disorder Society‐sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS‐UPDRS): Scale presentation and clinimetric testing results

Cited by 5,309 publications

References 10 publications

The Parkinson's progression markers initiative (PPMI) – establishing a PD biomarker cohort

The Parkinson's progression markers initiative (PPMI) – establishing a PD biomarker cohort

Relationships between activity and well‐being in people with parkinson's disease

Factors associated with motor complications in Parkinson's disease

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