A proposal for a comprehensive grading of Parkinson's disease severity combining motor and non-motor assessments: meeting an unmet need.

<h4>Background</h4>Non-motor symptoms are present in Parkinson's disease (PD) and a key determinant of quality of life. The Non-motor Symptoms Scale (NMSS) is a validated scale that allows quantifying frequency and severity (burden) of NMS. We report a proposal for using NMSS scores...

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Autores principales: Kallol Ray Chaudhuri, Jose Manuel Rojo, Anthony H V Schapira, David J Brooks, Fabrizio Stocchi, Per Odin, Angelo Antonini, Richard G Brown, Pablo Martinez-Martin
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Publicado: Public Library of Science (PLoS) 2013
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spelling oai:doaj.org-article:7f23afca1ad64ec09e622038810af64e2021-11-18T07:55:40ZA proposal for a comprehensive grading of Parkinson's disease severity combining motor and non-motor assessments: meeting an unmet need.1932-620310.1371/journal.pone.0057221https://doaj.org/article/7f23afca1ad64ec09e622038810af64e2013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23468940/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Non-motor symptoms are present in Parkinson's disease (PD) and a key determinant of quality of life. The Non-motor Symptoms Scale (NMSS) is a validated scale that allows quantifying frequency and severity (burden) of NMS. We report a proposal for using NMSS scores to determine levels of NMS burden (NMSB) and to complete PD patient classification.<h4>Methods</h4>This was an observational, cross-sectional international study of 935 consecutive patients. Using a distribution of NMSS scores by quartiles, a classification based on levels from 0 (no NMSB at all) to 4 (very severe NMSB) was obtained and its relation with Hoehn and Yahr (HY) staging, motor and health-related quality of life scales was analyzed. Concordance between NMSB levels and grouping based on clinician's global impression of severity, using categorical regression, was determined. Disability and HRQoL predictors were identified by multiple regression models.<h4>Results</h4>The distribution of motor and QoL scales scores by HY and NMSB levels was significantly discriminative. The difference in the classification of cases for both methods, HY and NMSB, was significant (gamma = 0.45; ASE = 0.032). Concordance between NMSB and global severity-based levels from categorical regression was 91.8%, (kappaw = 0.97). NMS score was predictor of disability and QoL.<h4>Conclusions</h4>Current clinical practice does not address a need for inclusion of non-motor scores in routine assessment of PD in spite of the overwhelming influence of NMS on disability and quality of life. Our data overcome the problems of "pure motor assessment" and we propose a combined approach with addition of NMSB levels to standard motor assessments.Kallol Ray ChaudhuriJose Manuel RojoAnthony H V SchapiraDavid J BrooksFabrizio StocchiPer OdinAngelo AntoniniRichard G BrownPablo Martinez-MartinPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 8, Iss 2, p e57221 (2013)
institution DOAJ
collection DOAJ
language EN
topic Medicine
R
Science
Q
spellingShingle Medicine
R
Science
Q
Kallol Ray Chaudhuri
Jose Manuel Rojo
Anthony H V Schapira
David J Brooks
Fabrizio Stocchi
Per Odin
Angelo Antonini
Richard G Brown
Pablo Martinez-Martin
A proposal for a comprehensive grading of Parkinson's disease severity combining motor and non-motor assessments: meeting an unmet need.
description <h4>Background</h4>Non-motor symptoms are present in Parkinson's disease (PD) and a key determinant of quality of life. The Non-motor Symptoms Scale (NMSS) is a validated scale that allows quantifying frequency and severity (burden) of NMS. We report a proposal for using NMSS scores to determine levels of NMS burden (NMSB) and to complete PD patient classification.<h4>Methods</h4>This was an observational, cross-sectional international study of 935 consecutive patients. Using a distribution of NMSS scores by quartiles, a classification based on levels from 0 (no NMSB at all) to 4 (very severe NMSB) was obtained and its relation with Hoehn and Yahr (HY) staging, motor and health-related quality of life scales was analyzed. Concordance between NMSB levels and grouping based on clinician's global impression of severity, using categorical regression, was determined. Disability and HRQoL predictors were identified by multiple regression models.<h4>Results</h4>The distribution of motor and QoL scales scores by HY and NMSB levels was significantly discriminative. The difference in the classification of cases for both methods, HY and NMSB, was significant (gamma = 0.45; ASE = 0.032). Concordance between NMSB and global severity-based levels from categorical regression was 91.8%, (kappaw = 0.97). NMS score was predictor of disability and QoL.<h4>Conclusions</h4>Current clinical practice does not address a need for inclusion of non-motor scores in routine assessment of PD in spite of the overwhelming influence of NMS on disability and quality of life. Our data overcome the problems of "pure motor assessment" and we propose a combined approach with addition of NMSB levels to standard motor assessments.
format article
author Kallol Ray Chaudhuri
Jose Manuel Rojo
Anthony H V Schapira
David J Brooks
Fabrizio Stocchi
Per Odin
Angelo Antonini
Richard G Brown
Pablo Martinez-Martin
author_facet Kallol Ray Chaudhuri
Jose Manuel Rojo
Anthony H V Schapira
David J Brooks
Fabrizio Stocchi
Per Odin
Angelo Antonini
Richard G Brown
Pablo Martinez-Martin
author_sort Kallol Ray Chaudhuri
title A proposal for a comprehensive grading of Parkinson's disease severity combining motor and non-motor assessments: meeting an unmet need.
title_short A proposal for a comprehensive grading of Parkinson's disease severity combining motor and non-motor assessments: meeting an unmet need.
title_full A proposal for a comprehensive grading of Parkinson's disease severity combining motor and non-motor assessments: meeting an unmet need.
title_fullStr A proposal for a comprehensive grading of Parkinson's disease severity combining motor and non-motor assessments: meeting an unmet need.
title_full_unstemmed A proposal for a comprehensive grading of Parkinson's disease severity combining motor and non-motor assessments: meeting an unmet need.
title_sort proposal for a comprehensive grading of parkinson's disease severity combining motor and non-motor assessments: meeting an unmet need.
publisher Public Library of Science (PLoS)
publishDate 2013
url https://doaj.org/article/7f23afca1ad64ec09e622038810af64e
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