3 research outputs found
Planimetric and Volumetric Brainstem MRI Markers in Progressive Supranuclear Palsy, Multiple System Atrophy, and Corticobasal Syndrome. A Systematic Review and Meta-Analysis
Background: Various MRI markersâincluding midbrain and pons areas (Marea, Parea) and volumes (Mvol, Pvol), ratios (M/Parea, M/Pvol), and composite markers (magnetic resonance imaging Parkinsonism Indices 1,2; MRPI 1,2)âhave been proposed as imaging markers of Richardsonâs syndrome (RS) and multiple system atrophyâParkinsonism (MSA-P). A systematic review/meta-analysis of relevant studies aiming to compare the diagnostic accuracy of these imaging markers is lacking. Methods: Pubmed and Scopus were searched for studies with >10 patients (RS, MSA-P or CBS) and >10 controls with data on Marea, Parea, Mvol, Pvol, M/Parea, M/Pvol, MRPI 1, and MRPI 2. Cohenâs d, as a measure of effect size, was calculated for all markers in RS, MSA-P, and CBS. Results: Twenty-five studies on RS, five studies on MSA-P, and four studies on CBS were included. Midbrain area provided the greatest effect size for differentiating RS from controls (Cohenâs d = â3.10; p area and MRPI 1. MSA-P had decreased midbrain and pontine areas. Included studies exhibited high heterogeneity, whereas publication bias was low. Conclusions: Midbrain area is the optimal MRI marker for RS, and pons area is optimal for MSA-P. M/Parea and MRPIs produce smaller effect sizes for differentiating RS from controls
Applications of the European Parkinson's Disease Association sponsored Parkinson's Disease Composite Scale (PDCS).
This study was addressed to determine the presence of Parkinson disease (PD) manifestations, their distribution according to motor subtypes, and the relationships with health-related quality of life (QoL) using the recently validated European Parkinson's Disease Association sponsored Parkinson's Disease Composite Scale (PDCS). Frequency of symptoms was determined by the scores of items (present if >0). Using ROC analysis and Youden method, MDS-UPDRS motor subtypes were projected on the PDCS to achieve a comparable classification based on the PDCS scores. The same method was used to estimate severity levels from other measures in the study. The association between the PDCS and QoL (PDQ-39) was analyzed by correlation and multiple linear regression. The sample consisted of 776 PD patients. We found that the frequency of PD manifestations with PDCS and MDS-UPDRS were overlapping, the average difference between scales being 5.5% only. Using the MDS-UPDRS subtyping, 215 patients (27.7%) were assigned as Tremor Dominant (TD), 60 (7.7%) Indeterminate, and 501 (64.6%) Postural Instability and Gait Difficulty (PIGD) in this cohort. With this classification as criterion, the analogous PDCS-based ratio provided these cut-off values: TD subtype, =1.06; Indeterminate, 0.65; and PIGD, <0.65. The agreement between the two scales on this classification was substantial (87.6%; kappa = 0.69). PDCS total score cut-offs for PD severity were: 23/24 for mild/moderate and 41/42 for moderate/severe. Moderate to high correlations ( r = 0.35-0.80) between PDCS and PDQ-39 were obtained, and the four PDCS domains showed a significant independent influence on QoL. The conclusions are: (1) the PDCS assessed the frequency of PD symptoms analogous to the MDS-UPDRS; (2) motor subtypes and severity levels can be determined with the PDCS; (3) a significant association between PDCS and QoL scores [email protected]
Extensive validation study of the Parkinson's Disease Composite Scale
Background and purpose A composite instrument able to rapidly and
reliably assess the most relevant motor and non-motor afflictions
suffered by Parkinsonâs disease (PD) patients in a real world clinic
setting is an unmet need. The recently validated PD Composite Scale
(PDCS) was designed to fulfil this gap as a quick, comprehensive PD
assessment. The objective of this study was extensive evaluation of the
PDCSâs clinimetric properties using a large international sample.
Methods This was a cross-sectional study in which the PDCS, the Movement
Disorder Society Unified Parkinsonâs Disease Rating Scale and the
Clinical Impression of Severity Index for PD were applied. Basic
clinimetric attributes of the PDCS were analysed. Results In total, 776
PD patients were included. The PDCS total score showed negligible floor
and ceiling effects. Three factors (54.5% of the variance) were
identified: factor 1 included motor impairment, fluctuations and
disability; factor 2, non-motor symptoms; and factor 3, tremor and
complications of therapy. Cronbachâs alpha was from 0.66 to 0.79.
Inter-rater reliability showed weighted kappa values from 0.79 to 0.98
for items and intraclass correlation coefficient values from 0.95
(Disability) to 0.99 (Motor and total score). The Bland-Altmann method,
however, showed irregular concordance. PDCS standard error of
measurement and convergent validity with equivalent constructs of other
measures were satisfactory (>= 0.70). PDCS scores significantly differed
by Hoehn and Yahr stage. Conclusion Overall, in line with previous
findings, the PDCS is a feasible, acceptable, valid, reliable and
precise instrument for quickly and comprehensively assessing PD
patients