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...

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Publicado en:Movement Disorders Vol. 34; no. 10; pp. 1480 - 1488
Autores principales: Evers, Luc J.W., Krijthe, Jesse H., Meinders, Marjan J., Bloem, Bastiaan R., Heskes, Tom M.
Formato: research tables/charts Journal Article
Publicado: Wiley-Blackwell Oct2019
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Oct2019
      vid: 34
      iid: 10
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        10.1002/mds.27790
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        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
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