Validation of the Korean-Version of the Nonmotor Symptoms Scale for Parkinson's Disease

Abstract

Background and PurposeNon-motor symptoms are common in Parkinson's disease (PD), and are the primary cause of disability in many PD patients. Our aim in this study was to translate the origin non-motor symptoms scale for PD (NMSS), which was written in English, into Korean (K-NMSS), and to evaluate its reliability and validity for use with Korean-speaking patients with PD.MethodsIn total, 102 patients with PD from 9 movement disorders sections of university teaching hospitals in Korea were enrolled in this study. They were assessed using the K-NMSS, the Unified Parkinson's Disease Rating Scale (UPDRS), the Korean version of the Mini-Mental Status Examination (K-MMSE), the Korean version of the Montgomery-Asberg Depression Rating Scale (K-MADS), the Epworth Sleepiness Scale (ESS), and Parkinson's Disease Questionnaire 39 (PDQ39). Test-retest reliability was assessed over a time interval of 10-14 days in all but one patient.ResultsThe K-NMSS was administered to 102 patients with PD. The internal consistency and reliability of this tool was 0.742 (mean Cronbach's α-coefficient). The test-retest correlation reliability was 0.941 (Guttman split-half coefficient). There was a moderate correlation between the total K-NMSS score and the scores for UPDRS part I [Spearman's rank correlation coefficient, (rS)=0.521, p<0.001] and UPDRS part II (rS=0.464, p=0.001), but there was only a weak correlation between the total K-NMSS score and the UPDRS part III score (rS=0.288, p=0.003). The total K-NMSS score was significantly correlated with the K-MADS (rS=0.594, p<0.001), K-MMSE (rS=-0.291, p=0.003), and ESS (rS=0.348, p<0.001). The total K-NMSS score was also significantly and positively correlated with the PDQ39 score (rS=0.814, p<0.001).ConclusionsThe K-NMSS exhibited good reliability and validity for the assessment of non-motor symptoms in Korean PD patients.

Normal ‘heart’ in Parkinson's disease: is this a distinct clinical phenotype?

“…(punched or flailed arms in the air, shouted or screamed).” If the RBD screening questionnaire test scores were ≥5 and question 1 of the Mayo questionnaire received a positive response (i.e. ‘yes’), then the patient was considered to have probable RBD . Excessive daytime sleepiness: defined with an Epworth Sleepiness Scale score >10 . Depression: (i) history of or current treatment for depressive symptoms and (ii) the unequivocal classification of depressive states according to DSM‐V diagnostic categories, as specified below. Anxiety: (i) history of or current treatment for anxiety disorders and (ii) DSM‐IV residual category of ‘anxiety disorder, not otherwise specified’. Orthostatic hypotension: defined with the head‐up tilt test using the Manumed Special Tilt1 section (Enraf‐Nonius, Rotterdam, the Netherlands). Tilt testing was performed after 20 min of supine rest.…”

“…'yes'), then the patient was considered to have probable RBD [17,18]. 4 Excessive daytime sleepiness: defined with an Epworth Sleepiness Scale score >10 [19]. 5 Depression: (i) history of or current treatment for depressive symptoms and (ii) the unequivocal classification of depressive states according to DSM-V diagnostic categories, as specified below.…”

Clinical phenotype of drug-naïve Parkinson’s disease based on nonmotor symptoms

“…(Ertan et al, 2005;Schrag et al, 2007) The 39-item Parkinson's Disease Questionnaire (PDQ-39) was used to evaluate the level of health-related quality of life and provided a summary index score (PDQ39 SI) (Peto et al, 1998) To evaluate and quantify NMS, a validated Korean version of the NMSS was used. (Koh et al, 2012) Since the NMSS does not include questions about RBD, the presence of RBD was separately assessed.…”

Nonmotor symptoms in essential tremor: Comparison with Parkinson's disease and normal control

“…For evaluation of several nonmotor features, the following questionnaires and scales were used for each domain of nonmotor symptoms: for overall nonmotor symptoms, the Korean version of the Nonmotor Symptoms Scale (K-NMSS) [16]; for cognition, the Korean version of the Mini-Mental State Exam (K-MMSE), and the Montreal Cognitive Assessment-Korea (MoCA-K); for psychiatric problems, the Montgomery-Asberg Depression Rating Scale (MADRS) [17], the Neuropsychiatric Inventory Questionnaire (NPI-Q), and the Beck Anxiety Inventory (BAI) [18]; for sleep problems, the Pittsburgh Sleep Quality Index (PSQI) [19] and the Epworth Sleepiness Scale (ESS) [20]; and for autonomic dysfunction, the Scales for Outcomes in Parkinson's Disease-Autonomic (SCOPA-AUT) [21]. The normal control group was evaluated using the same tools.…”