Measuring Parkinson's disease over time: The real-world within-subject reliability of the MDS-UPDRS.
Background: An important challenge in Parkinson's disease research is how to measure disease progression, ideally at the individual patient level. The MDS-UPDRS, a clinical assessment of motor and nonmotor impairments, is widely used in longitudinal studies. However, its ability to assess within-sub...
| Publicado en: | Movement Disorders Vol. 34; no. 10; pp. 1480 - 1488 |
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| Autores principales: | , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Oct2019
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=139190223&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 139190223 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 08853185 O71 jtl: Movement Disorders issn: 08853185 maglogo: Y pubinfo: dt: Oct2019 vid: 34 iid: 10 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 139190223 139190223 NLM31291488 139190223 10.1002/mds.27790 NLM31291488 139190223 ppf: 1480 ppct: 8 formats: tig: atl: Measuring Parkinson's disease over time: The real-world within-subject reliability of the MDS-UPDRS. aug: au: Evers, Luc J.W. Krijthe, Jesse H. Meinders, Marjan J. Bloem, Bastiaan R. Heskes, Tom M. affil: Radboud University Medical Center sug: subj: Tremor Physiopathology Parkinson Disease Therapy Tremor Therapy Parkinson Disease Diagnosis Disability Evaluation Human Linear Regression Female Parkinson Disease Physiopathology Tremor Diagnosis Middle Age Prospective Studies Disease Progression Male Adult Aged Validation Studies Comparative Studies Evaluation Research Multicenter Studies Scales Funding Source Middle Aged: 45-64 years Adult: 19-44 years Aged: 65+ years Female Male ab: Background: An important challenge in Parkinson's disease research is how to measure disease progression, ideally at the individual patient level. The MDS-UPDRS, a clinical assessment of motor and nonmotor impairments, is widely used in longitudinal studies. However, its ability to assess within-subject changes is not well known. The objective of this study was to estimate the reliability of the MDS-UPDRS when used to measure within-subject changes in disease progression under real-world conditions.Methods: Data were obtained from the Parkinson's Progression Markers Initiative cohort and included repeated MDS-UPDRS measurements from 423 de novo Parkinson's disease patients (median follow-up: 54 months). Subtotals were calculated for parts I, II, and III (in on and off states). In addition, factor scores were extracted from each part. A linear Gaussian state space model was used to differentiate variance introduced by long-lasting changes from variance introduced by measurement error and short-term fluctuations. Based on this, we determined the within-subject reliability of 1-year change scores.Results: Overall, the within-subject reliability ranged from 0.13 to 0.62. Of the subscales, parts II and III (OFF) demonstrated the highest within-subject reliability (both 0.50). Of the factor scores, the scores related to gait/posture (0.62), mobility (0.45), and rest tremor (0.43) showed the most consistent behavior.Conclusions: Our results highlight that MDS-UPDRS change scores contain a substantial amount of error variance, underscoring the need for more reliable instruments to forward our understanding of the heterogeneity in PD progression. Focusing on gait and rest tremor may be a promising approach for an early Parkinson's disease population. © 2019 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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