Quantifying the impact of dyskinesias in PD

Katzenschlager, Regina; Schrag, Anette; Evans, Andrew; Manson, A J; Carroll, Camille; Ottaviani, Donatella; Lees, A. J.; Hobart, JC

doi:10.1212/01.wnl.0000266669.18308.af

Cited by 40 publications

(21 citation statements)

References 37 publications

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“…The AIMS assesses the amplitude of dyskinesia in each limb whereas the Rush also incorporates a section on the impact of dyskinesia on certain activities of daily living such as putting on a coat. A recent scale, the PDYS-26, a patient-based questionnaire, focuses solely on the impact of dyskinesia on activities of daily living [289]. One main issue of these scales is that they cannot segregate the impact of dyskinesia and cardinal symptoms of PD on the performance of motor behaviors.…”

Section: Discussionmentioning

confidence: 99%

Drug-induced dyskinesia in Parkinson's disease. Should success in clinical management be a function of improvement of motor repertoire rather than amplitude of dyskinesia?

Daneault

Carignan

Sadikot

et al. 2013

BMC Med

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BackgroundDyskinesia, a major complication in the treatment of Parkinson's disease (PD), can require prolonged monitoring and complex medical management.DiscussionThe current paper proposes a new way to view the management of dyskinesia in an integrated fashion. We suggest that dyskinesia be considered as a factor in a signal-to-noise ratio (SNR) equation where the signal is the voluntary movement and the noise is PD symptomatology, including dyskinesia. The goal of clinicians should be to ensure a high SNR in order to maintain or enhance the motor repertoire of patients. To understand why such an approach would be beneficial, we first review mechanisms of dyskinesia, as well as their impact on the quality of life of patients and on the health-care system. Theoretical and practical bases for the SNR approach are then discussed.SummaryClinicians should not only consider the level of motor symptomatology when assessing the efficacy of their treatment strategy, but also breadth of the motor repertoire available to patients.

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Section: Discussionmentioning

confidence: 99%

Drug-induced dyskinesia in Parkinson's disease. Should success in clinical management be a function of improvement of motor repertoire rather than amplitude of dyskinesia?

Daneault

Carignan

Sadikot

et al. 2013

BMC Med

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“…This may be due to the low weight of this complication in UPDRS IV, thus, the low correlation with QoL. The recently validated scale quantifying the real impact of dyskinesia on PD patients [15], might prove useful to clarify this issue in future studies.…”

Section: Discussionmentioning

confidence: 99%

Impact of psychiatric symptoms and sleep disorders on the quality of life of patients with Parkinson’s disease

et al. 2010

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The objective of this study is to assess how the non-motor symptoms of Parkinson's disease (PD), such as depression, cognitive deterioration, neuropsychiatric and sleep disorders, affect the quality of life, and to compare them with the motor symptoms in order to determine their real impact. A cross-sectional study was designed including 99 patients (mean age 68.5 ± 9.9 years, duration of disease 8.7 ± 6.2 years). Demographic data, onset of PD, years on treatment with levodopa (LD), class of dopaminergic drug prescribed, and dosages were obtained. The following scales were used: quality of life (PDQ-39), Unified Parkinson's Disease Rating Scale (UPDRS I-IV), Parkinson Disease Sleep Scale (PDSS) and daytime sleepiness (Epworth), Mini-Mental State Examination, depression (HAM-D), and the neuropsychiatric inventory (NPI-10). The PDQ-39 summary index (PDQ-39 SI) was 24.7 ± 13.2. A linear regression model including all variables showed that four independent variables accounted for 67.2% of the variance in the PDQ-39 SI (F = 33,277; p < 0.001): NPI, PDSS, UPDRS IV, and UPDRS I. When sub-items of the NPI, PDSS and UPDRS IV scales are analyzed, significant correlations (p < 0.001) are found between the PDQ-39 SI and depression, agitation, apathy, anxiety, hallucinations, delusions, incontinence of urine, morning painful posturing, restlessness in bed, morning fatigue, duration of off periods, unpredictable and predictable off periods, early morning dystonia, and sudden off periods. Neuropsychiatric symptoms, especially depression, nighttime sleep disorders such as urinary incontinence, nighttime restlessness, morning fatigue and somnolence, off-period dystonia and motor fluctuations are the variables that most affect the quality of life of patients with PD.

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“…The PDYS‐26,20 is a 26‐item, patient‐based measure “for quantifying the impact of dyskinesia on activities of daily living” in PD. Items include basic, instrumental, and social daily activities.…”

Section: Scales For Dyskinesia In Pdmentioning

confidence: 99%

“…Later, it was validated by means of Rasch analysis, again, and also applying Classical Test Theory methods. There is only one study (the original article20) on the psychometric properties of the scale. As per this article, the scale has satisfactory acceptability, with no floor or ceiling effect (although neither standard nor observed values are given) and appropriate distribution of scores.…”

Section: Scales For Dyskinesia In Pdmentioning

confidence: 99%

Task force report on scales to assess dyskinesia in Parkinson's disease: Critique and recommendations

et al. 2010

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Drug-induced dyskinesia is a common phenomenon in Parkinson's disease (PD) and is often socially as well as physically disabling for patients. The Movement Disorders Society commissioned a task force to assess available clinical rating scales, critique their clinimetric properties, and make recommendations regarding their clinical utility. A task force composed six clinical researchers who systematically searched the literature for scales measuring dyskinesia in PD, evaluated the scales' previous use, performance parameters, and quality of validation data (if available). A scale was designated "Recommended" if the scale has been used in clinical studies beyond the group that developed it, has been specifically used in PD reports, and if clinimetric studies have established that it is a valid, reliable, and sensitive. "Suggested" scales met two of the above criteria and those meeting one were "Listed." Based on the systematic review, eight rating scales for dyskinesia that have either been validated or used in PD were identified. These were the Abnormal Involuntary Movement Scale (AIMS), The Unified Parkinson's Disease Rating Scale (UPDRS) part IV, the Obeso Dyskinesia Rating Scale, the Rush Dyskinesia Rating Scale, the Clinical Dyskinesia Rating Scale (CDRS), the Lang-Fahn Activities of Daily Living Dyskinesia Scale, the Parkinson Disease Dyskinesia Scale (PDYS-26), and the Unified Dyskinesia Rating Scale (UDysRS). Based on this review, at present two of the reviewed dyskinesia scales (AIMS and the Rush Dyskinesia Rating Scale) fulfill criteria for Recommended for use in PD populations, albeit weakly so; all of the remaining met criteria to be Suggested. However, the two most recent scales (PDYS-26 and UDysRS) have excellent clinimetric properties and appear to provide a reliable and valid assessment tool of dyskinesia in PD. If they are used successfully beyond the groups that developed them, both have the potential to be re-ranked as Recommended. As further testing of these scales in PD is warranted, no new scales are needed until the available scales are fully tested clinimetrically.

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Quantifying the impact of dyskinesias in PD

Cited by 40 publications

References 37 publications

Drug-induced dyskinesia in Parkinson's disease. Should success in clinical management be a function of improvement of motor repertoire rather than amplitude of dyskinesia?

Drug-induced dyskinesia in Parkinson's disease. Should success in clinical management be a function of improvement of motor repertoire rather than amplitude of dyskinesia?

Impact of psychiatric symptoms and sleep disorders on the quality of life of patients with Parkinson’s disease

Task force report on scales to assess dyskinesia in Parkinson's disease: Critique and recommendations

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