Assessing the non-motor symptoms of Parkinson's disease:MDS-UPDRS and NMS Scale

Background and purpose Although Parkinson's disease (PD) is characterized by typical motor manifestations, non‐motor symptoms (NMS) are an outstanding part of the disease. At present, several specific instruments for assessment of NMS are available. The objective of our study was to determine the performance of the Movement Disorder Society‐Unified Parkinson's Disease Rating Scale (MDS‐UPDRS): Part I – Non‐Motor Aspects of Experiences of Daily Living (nM‐EDL) compared with the Non‐Motor Symptoms Scale (NMSS). Methods To this purpose, 434 consecutive patients with PD were included in an international, observational, cross‐sectional study. The association between scores of both scales was determined by the Spearman rank correlation coefficient. Equations for transformation of total score of a scale to the other were constructed from weighted regression models and both, transformed and observed score, contrasted by means of the Lin's Concordance Correlation Coefficient (LCCC) and Bland–Altman plot. Results As a whole, the prevalence of the NMS according to each scale was quite similar, and most of the correlations between their corresponding components were high (rS > 0.60). The total score correlation of the MDS‐UPDRS Part I with the NMSS was high (rS = 0.81). Concerning the transformed scores, estimated scores only partially approach the observed ones (sharing about 60–64% of the variance) because residual variance increased with increasing magnitudes of the scores, i.e. the most severe patients (Bland–Altman plot; LCCC < 0.60 for severe patients). Conclusions (i) MDS‐UPDRS Part I (nM‐EDL) and NMSS showed a strong convergent validity; (ii) however, transformed scores using the equations from weighted regression models showed that for patients with the most severe NMS they are not concordant. Click here to view the accompanying paper in this issue

Differences in MDS-UPDRS Scores Based on Hoehn and Yahr Stage and Disease Duration

BACKGROUND: The Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS‐UPDRS) is a newly developed tool to assess Parkinson's disease (PD). Changes in scores on the scale over the course of PD, including increasing disease duration and Hoehn and Yahr (HY) stages, have not been described. The objectives of this study were to analyze MDS‐UPDRS scores on Parts I through IV and their differences based on HY stage and disease duration in a large cohort of patients with PD. METHODS: For this cross‐sectional study, demographic data and MDS‐UPDRS scores were collected, including HY stage. Subscores on MDS‐UPDRS Parts I through IV were analyzed using 1‐way analyses of variance for each HY stage and in 5‐year increments of disease duration. Part III (motor assessment) scores were analyzed separately for on and off states. RESULTS: The mean age of the 3206 patients was 65.8 ± 10.6 years, 53.3% were men, the mean disease duration was 11.5 ± 4.6 years, and the median HY stage was 2 (range, 0–5); 2156 patients were examined in an on state and 987 were examined in an off state. Scores for all MDS‐UPDRS parts increased significantly through HY stages 1 through 5, with an average increase of 3.8, 7.7, 14.6, and 2.0 points consecutively for parts I through IV, respectively. For the 5‐year increments of disease duration, MDS‐UPDRS subscores increased by an average of 1.6, 3.3, 4.2, and 1.4 points consecutively for parts I through IV, respectively. This increase was significant only during the first 15 years of disease for all 4 parts, including part III scores evaluated in both on and off states. CONCLUSIONS: MDS‐UPDRS scores for all 4 parts increase significantly with every HY stage and also with 5‐year increments of disease duration in the first 15 years of the disease

Evaluación de la cognición social y teoría de la mente en pacientes con enfermedad cerebelosa degenerativa aislada no dementes Social cognition and theory of mind assessment in non-demented patients with isolated cerebellar degeneration

OBJETIVO: Investigar la hipótesis según la cual, el cerebelo podría participar en las alteraciones de la cognición social (CS). MÉTODO: Se administraron tests neuropsicológicos generales, de función ejecutiva (FE), de CS que evaluaban la capacidad de inferir el estado mental de otras personas y la escala de Depresión de Beck a 10 pacientes adultos con enfermedad cerebelosa adquirida aislada (GEC) y a 10 controles (GCO) apareados por edad, sexo y educación. Se analizaron los datos mediante ANOVA y correlación. RESULTADOS: El GEC obtuvo puntajes significativamente menores (p?0,05) que el grupo GCO en tareas de FE (Test de Wisconsin) y preguntas de creencia (PCr) de Teoría de la Mente (ToM). El rendimiento en las preguntas de control (PCo) de ToM fue similar en ambos grupos. El menor rendimiento en las PCr correlacionó significativamente con una menor habilidad conceptual, la severidad de la apatía (NPI) y de la ataxia estática. Las PCo correlacionaron con medidas de atención y de recuerdo diferido libre. CONCLUSÍON: El cerebelo contribuiría en el monitoreo de la conducta mediante el control de datos multimodales motores, cognitivos y emocionales.<br>AIM: To investigate whether the cerebellum could participate in social cognition (SC). METHOD: General neuropsychological tests, executive tests (EF), social cognition tests, which assess the ability to infer other peoples’ mental states, and the Beck Depression Inventory were given to 10 non-demented patients with isolated cerebellar degenerative disease, and to 10 healthy controls matched for sex, age, and years of education. ANOVA and correlation coefficients were employed for the statistical analysis. RESULTS: Patients within the cerebellar group were significantly impaired (p?0.05) in EF test [Wisconsin Card Sorting Test (WSCT)] and belief questions (BQ) from Theory of Mind (ToM) tests. Performance in control questions (CQ) from ToM tests was similar for both groups. Lower scores in BQ correlated with a lower conceptual ability, the severity of apathy (NPI) and static ataxia. CQ correlated with measures of attention and free recall. CONCLUSION: The cerebellum may contribute in the control of social behavior through the processing of multimodal data, motor, cognitive and emotional