Validation of the Hungarian Unified Dyskinesia Rating Scale

et al. 2016

Parkinson's Disease

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Background. Female Parkinson's disease (PD) patients seem to experience not only more severe motor complications and postural instability but also more pronounced depression, anxiety, pain, and sleep disturbances. Objective. The aim of the present study was to evaluate the role of sex as a possible independent predictor of HRQoL in PD. Methods. In this cross-sectional study, 621 consecutive patients treated at the University of Pécs were enrolled. Severity of PD symptoms was assessed by MDS-UPDRS, UDysRS, Non-Motor Symptoms Scale, PDSS-2, Hamilton Anxiety Scale, Montgomery-Asberg Depression Rating Scale, Lille Apathy Rating Scale, and Addenbrooke Cognitive Examination. HRQoL was assessed by PDQ-39 and EQ-5D. Multiple regression analysis was performed to estimate the PDQ-39 and EQ-5D index values based on various clinical factors. Results. Although females received significantly lower dosage of levodopa, they had significantly more disabling dyskinesia and worse postural instability. Anxiety, pain, sleep disturbances, and orthostatic symptoms were more frequent among females while sexual dysfunction, apathy, and daytime sleepiness were more severe among males. Women had worse HRQoL than men (EQ-5D index value: 0.620 ± 0.240 versus 0.663 ± 0.229, p = 0.025, and PDQ-39 SI: 27.1 ± 17.0 versus 23.5 ± 15.9, p = 0.010). Based on multiple regression analysis, sex was an independent predictor for HRQoL in PD. Conclusions. Based on our results, female sex is an independent predictor for having worse HRQoL in PD.

Section: Methodsmentioning

confidence: 99%

Impact of Sex on the Nonmotor Symptoms and the Health-Related Quality of Life in Parkinson’s Disease

Kovács

Makkos

et al. 2016

Parkinson's Disease

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“…Each patient was examined by neurologists specialized in movement disorders. Portion of these patients (357/537) participated in the program of cultural adaptation and validation of the Movement Disorders Society-sponsored Unified Parkinson's Disease Rating Scale (MDS-UPDRS) 11 and Unified Dyskinesia Rating Scale 12 into Hungarian.…”

Section: Patientsmentioning

confidence: 99%

Independent validation of Parkinson’s disease Sleep Scale 2nd version (PDSS-2)

Kovács

Horváth

et al. 2015

Sleep Biol. Rhythms

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Sleep problems are one of the most common non-motor symptoms of Parkinson's disease (PD). The Parkinson's disease Sleep Scale 2 nd version (PDSS-2) was published in 2011 showing satisfactory clinimetric results. We performed an independent testing of the scale adding further information on its clinimetric properties.In this nationwide study 537 PD patients were enrolled. Besides PDSS-2, we assessed Patient's Global Impression-Severity (PGI) scale on sleep disturbances, Non-motor Symptoms Scale and MDS-UPDRS.Following the Classical Theory of Tests we performed descriptive data analysis, factor analysis, reliability, validity and precision measurements. Subsequently, we evaluated cut-off value for detecting clinically meaningful sleep problems based on receiver operating characteristics analysis.Based on the PGI scale, 161 patients (30.0%) did not reported any sleep problems. Factor analysis revealed almost the same factor structure described by the original PDSS-2 validation study. Cronbach's alpha was 0.863 and all item had good item-total correlation. PDSS-2 demonstrated high convergent validity with Non-Motor Symptoms Scale and Clinical Global Impression-Severity and non-motor part of MDS-UPDRS, and divergent validity with age, gender, education-level, disease-duration and Hoehn-Yahr Stages.Presence of sleep problems was identified by scores >10.5 points on PDSS-2 (sensitivity: 85.3%, specificity: 60.8%, diagnostic accuracy: 78.1%); whereas scores >19.5 points indicated marked sleep-related problems (specificity: 68.5%, sensitivity: 78.0%, diagnostic accuracy: 74.3%).Independent and cross-cultural validation of patient reported outcomes is essential to confirm or reject the findings obtained by the developers of the scale. Our results demonstrate that fundamental clinimetric properties of the PDSS-2 are satisfactory.

“…Severity of PD symptoms was globally assessed by the Hungarian validated version of the MDS-UPDRS [17]. The recently published MDS-UPDRS is a validated scale to assess non-motor aspects (Part 1) and motor aspects (Part 2) of experiences of daily living, motor examination (Part 3) and motor complications (Part 4) [18].…”

Section: Rating Scales Utilized In the Studymentioning

confidence: 99%

Bilateral Subthalamic Stimulation can Improve Sleep Quality in Parkinson’s Disease

Deli

Ács

et al. 2015

JPD

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Abstract.Background: Sleep problems are among the most common non-motor symptoms of Parkinson's disease (PD). The PD Sleep Scale 2nd version (PDSS-2) improved the original PDSS by adding more items on different aspects of sleep problems, making it a more robust tool to evaluate the severity of sleep disturbances. However, previous studies on deep brain stimulation (DBS) have not used the PDSS-2. Objective: To determine if the PDSS-2 could detect improvement reliably in sleep problems after bilateral subthalamic nucleus DBS for PD. Methods: In this prospective study, 25 consecutive patients undergoing DBS implantation were enrolled. Patients were examined twice: 1 week prior to the DBS implantation (baseline) and 12 months postoperatively. Severity of PD symptoms were assessed by the Movement Disorders Society Unified PD Rating Scale (MDS-UPDRS) and the Non-Motor Symptoms Scale (NMSS). Presence and severity of sleep disturbances were specifically measured by PDSS-2. Results: Total score of MDS-UPDRS improved from 81 (median, interquartile-range: 63-103) to 55 points (median, IQR: 46-75, p < 0.001). Health-related quality of life, measured by PDQ-39, also improved from 29 (IQR: 18-40) to 15 (IQR: 9-28) points (p = 0.002). Most domains of NMSS also improved. At baseline 13 patients reported sleep problems, but 1 year after DBS implantation only 3 did (p = 0.012). Although only 6 out of 15 items showed a significant decrease after DBS implantation, the total score of PDSS-2 decreased from 24 (IQR: 17-32) to 10 (IQR: 7-18) points (P < 0.001). Conclusions: Based on our results, PDSS-2 can detect improvements in sleep quality reliably after DBS implantation.