Minimal Clinically Important Difference on Parkinson’s Disease Sleep Scale 2nd Version

Background and Aims. The aim of the present study was to determine the estimates of minimal clinically important difference for Parkinson’s Disease Sleep Scale 2nd version (PDSS-2) total score and dimensions.Methods. The subject population consisted of 413 PD patients. At baseline, MDS-UPDRS, Hoehn-Yahr Scale, Mattis Dementia Rating Scale, and PDSS-2 were assessed. Nine months later the PDSS-2 was reevaluated with the Patient-Reported Global Impression Improvement Scale. Both anchor-based techniques (within patients’ score change method and sensitivity- and specificity-based method by receiver operating characteristic analysis) and distribution-based approaches (effect size calculations) were utilized to determine the magnitude of minimal clinically important difference.Results. According to our results, any improvements larger than −3.44 points or worsening larger than 2.07 points can represent clinically important changes for the patients. These thresholds have the effect size of 0.21 and −0.21, respectively.Conclusions. Minimal clinically important differences are the smallest change of scores that are subjectively meaningful to patients. Studies using the PDSS-2 as outcome measure should utilize the threshold of −3.44 points for detecting improvement or the threshold of 2.07 points for observing worsening.

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Minimal Clinically Important Difference in Parkinson’s Disease as Assessed in Pivotal Trials of Pramipexole Extended Release

Parkinson s Disease ◽

10.1155/2014/467131 ◽

2014 ◽

Vol 2014 ◽

pp. 1-8 ◽

Cited By ~ 13

Author(s):

Robert A. Hauser ◽

Mark Forrest Gordon ◽

Yoshikuni Mizuno ◽

Werner Poewe ◽

Paolo Barone ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Minimal Clinically Important Difference ◽

Rating Scale ◽

Immediate Release ◽

Double Blind ◽

Clinically Important Difference ◽

Parallel Group ◽

The Mean ◽

Off Time

Background. The minimal clinically important difference (MCID) is the smallest change in an outcome measure that is meaningful for patients.Objectives. To calculate the MCID for Unified Parkinson’s Disease Rating Scale (UPDRS) scores in early Parkinson’s disease (EPD) and for UPDRS scores and “OFF” time in advanced Parkinson’s disease (APD).Methods. We analyzed data from two pivotal, double-blind, parallel-group trials of pramipexole ER that included pramipexole immediate release (IR) as an active comparator. We calculated MCID as the mean change in subjects who received active treatment and rated themselves “a little better” on patient global impression of improvement (PGI-I) minus the mean change in subjects who received placebo and rated themselves unchanged.Results. MCIDs in EPD (pramipexole ER, pramipexole IR) for UPDRS II were −1.8 and −2.0, for UPDRS III −6.2 and −6.1, and for UPDRS II + III −8.0 and −8.1. MCIDs in APD for UPDRS II were −1.8 and −2.3, for UPDRS III −5.2 and −6.5, and for UPDRS II + III −7.1 and −8.8. MCID for “OFF” time (pramipexole ER, pramipexole IR) was −1.0 and −1.3 hours.Conclusions. A range of MCIDs is emerging in the PD literature that provides the basis for power calculations and interpretation of clinical trials.

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Comparative sensitivity of the MoCA and Mattis Dementia Rating Scale‐2 in Parkinson's disease

Movement Disorders ◽

10.1002/mds.27575 ◽

2018 ◽

Vol 34 (2) ◽

pp. 285-291 ◽

Cited By ~ 4

Author(s):

Taylor R. Hendershott ◽

Delphine Zhu ◽

Seoni Llanes ◽

Cyrus P. Zabetian ◽

Joseph Quinn ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Rating Scale ◽

Comparative Sensitivity ◽

Mattis Dementia Rating Scale ◽

Dementia Rating Scale

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Urinary dysfunction with detrusor hyperactivity in women with Parkinson's disease cannot be blamed as a factor of worsening motor performance

Arquivos de Neuro-Psiquiatria ◽

10.1590/0004-282x20130101 ◽

2013 ◽

Vol 71 (9A) ◽

pp. 591-595 ◽

Cited By ~ 6

Author(s):

Raimundo Nonato Campos-Sousa ◽

Elizabeth Maria Aparecida Barasnevicius Quagliato ◽

Kelson James Almeida ◽

Inacio Augusto Dias de Castro ◽

Viriato Campelo

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Motor Performance ◽

Rating Scale ◽

Clinical Symptoms ◽

Urinary Dysfunction ◽

Clinical Aspects ◽

Yahr Scale ◽

Disease Rating ◽

Detrusor Hyperactivity

Introduction Detrusor hyperactivity is the leading cause of urinary dysfunction in Parkinson's disease (PD). There are few studies correlating PD clinical aspects with this autonomic feature. Methods A cohort of 63 women with PD were prospectively examined for assessment of clinical aspects and disease severity using unified Parkinson's disease rating scale and Hoehn-Yahr scale, respectively. The urologic function was evaluated by the urodynamic study. Two groups were categorized at this time - groups with and without detrusor hyperactivity. After seven years, the same parameters were re-evaluated. Results Progression of the disease on mental scores was found in the group with detrusor hyperactivity. On follow-up, clinical symptoms and severity did not show significant worsening between the groups. Conclusion Detrusor hyperactivity is a frequent urodynamic finding in PD, and even though it is associated with dopaminergic dysfunction, it cannot be blamed as a factor of worsening motor performance, but is probably associated with poor cognitive and mental prognosis.

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Retinal Morphological Changes during the Two Years of Follow-Up in Parkinson's Disease

10.21203/rs.3.rs-17217/v1 ◽

2020 ◽

Author(s):

Mahmut Atum ◽

Bekir Enes Demiryurek

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Rating Scale ◽

Early Stage ◽

Morphological Changes ◽

Fiber Layer ◽

Significant Difference ◽

Yahr Scale ◽

And Control

Abstract Background: The study aims to investigate the relationship between the progression of idiopathic Parkinson's disease (IPD) and retinal morphology. Methods: The study was carried out with 23 patients diagnosed with early-stage IPD (phases 1 and 2 of the Hoehn and Yahr scale) and 30 age-matched healthy controls. All patients were followed up at least two years, with 6-month intervals (initial, 6th month, 12th month, 18th month, and 24th month), and detailed neurological and ophthalmic examinations were performed at each follow-up. Unified Parkinson's Disease Rating Scale part III (UPDRS Part III) scores, Hoehn and Yahr (H&Y) scores, best-corrected visual acuity (BCVA), intraocular pressure (IOP) measurement, central macular thickness (CMT) and retinal nerve fiber layer (RNFL) thickness were analyzed at each visit. Results: The average age of the IPD and control groups was 43.96 ± 4.88 years, 44.53 ± 0.83 years, respectively. The mean duration of the disease in the IPD group was 7.48 ± 5.10 months at the start of the study (range 0-16). There was no statistically significant difference in BCVA and IOP values between the two groups during the two-year follow-up period (p> 0.05, p> 0.05, respectively). Average and superior quadrant RNFL thicknesses were statistically different between the two groups at 24 months and there was no significant difference between other visits (p = 0.025, p=0.034, p> 0.05, respectively). There was no statistically significant difference in CMT between the two groups during the follow-up period (p> 0.05). Conclusion: Average and superior quadrant RNFL thicknesses were significantly thinning with the progression of IPD.

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Minimal Clinically Important Difference of Patient Reported Outcome Measures of Lower Extremity Injuries in Orthopedics

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967117s00072 ◽

2017 ◽

Vol 5 (2_suppl2) ◽

pp. 2325967117S0007 ◽

Cited By ~ 2

Author(s):

Derya Çelik ◽

Özge Çoban ◽

Önder Kılıçoğlu

Keyword(s):

Lower Extremity ◽

Outcome Measures ◽

Minimal Clinically Important Difference ◽

Rating Scale ◽

Patient Reported Outcome Measures ◽

Patient Reported Outcome ◽

Foot And Ankle ◽

Clinically Important Difference ◽

Outcome Score ◽

Patient Reported

Purpose: MCID scores for outcome measures are frequently used evidence-based guides to gage meaningful changes. To conduct a systematic review of the quality and content of the the minimal clinically important difference (MCID) relating to 16 patient-rated outcome measures (PROM) used in lower extremity. Methods: We conducted a systematic literature review on articles reporting MCID in lower extremity outcome measures and orthopedics from January 1, 1980, to May 10, 2016. We evaluated MCID of the 16 patient reported outcome measures (PROM) which were Harris Hip Score (HHS), Oxford Hip Score (OHS), Hip Outcome Score (HOS), Hip Disability and Osteoarthritis Outcome Score (HOOS), The International Knee Documentation Committee Subjective Knee Form (IKDC), The Lysholm Scale, The Western Ontario Meniscal Evaluation Tool (WOMET), The Anterior Cruciate Ligament Quality of Life Questionnaire (ACL-QOL), The Lower Extremity Functional Scale (LEFS), The Western Ontario and Mcmaster Universities Index (WOMAC), Knee İnjury And Osteoarthritis Outcome Score (KOOS), Oxford Knee Score (OKS), Kujala Anterior Knee Pain Scale, The Victorian Institute of Sports Assessment Patellar Tendinosis (Jumper’s Knee) (VİSA-P), Tegner Activity Rating Scale, Marx Activity Rating Scale, Foot And Ankle Outcome Score (FAOS), The Foot Function Index (FFI), Foot And Ankle Ability Measure (FAAM), The Foot And Ankle Disability Index Score and Sports Module, Achill Tendon Total Rupture Score(ATRS), The Victorian İnstitute Of Sports Assesment Achilles Questionnaire(VİSA-A), American Orthopaedic Foot and Ankle Society (AOFAS). A search of the PubMed/MEDLINE, PEDro and Cochrane Cen¬tral Register of Controlled Trials and Web of Science databases from the date of inception to May 1, 2016 was conducted. The terms “minimal clinically important difference,” “minimal clinically important change”, “minimal clinically important improvement” “were combined with one of the PROM as mentioned above. Results: A total of 223 abstracts were reviewed and 119 articles chosen for full text review. Thirty articles were included in the final evaluation. The MCID was mostly calculated for WOMAC and frequently reported in knee and hip osteoartritis, knee and hip atrhroplasties, femoraasetabular impingement syndrome and focal cartilage degeneration. In addition, Receiver Operating Characteristic (ROC) analysis was the most used method to report MCID. Conclusions: MCID is an important concept used to determine whether a medical intervention improves perceived outcomes in patients. Despite an abundance of methods reported in the literature, little work in MCID estimation has been done in the PRAM related to lower extremity. There is a need for future studies in this regard.

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Predictors of second-sided deep brain stimulation for Parkinson’s disease

Journal of Neurosurgery ◽

10.3171/2019.12.jns19638 ◽

2020 ◽

pp. 1-7

Author(s):

Joshua L. Golubovsky ◽

Hong Li ◽

Arbaz Momin ◽

Jianning Shao ◽

Maxwell Y. Lee ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Deep Brain Stimulation ◽

Brain Stimulation ◽

Rating Scale ◽

Intraoperative Complications ◽

Cohort Analysis ◽

Initial Surgery ◽

Patient Reported ◽

Deep Brain

OBJECTIVEParkinson’s disease (PD) is a progressive neurological movement disorder that is commonly treated with deep brain stimulation (DBS) surgery in advanced stages. The purpose of this study was to investigate factors that affect time to placement of a second-sided DBS lead for PD when a unilateral lead is initially placed for asymmetrical presentation. The decision whether to initially perform unilateral or bilateral DBS is largely based on physician and/or patient preference.METHODSThis study was a retrospective cohort analysis of patients with PD undergoing initial unilateral DBS for asymmetrical disease between January 1999 and December 2017 at the authors’ institution. Patients treated with DBS for essential tremor or other conditions were excluded. Variables collected included demographics at surgery, time since diagnosis, Unified Parkinson’s Disease Rating Scale motor scores (UPDRS-III), patient-reported quality-of-life outcomes, side of operation, DBS target, intraoperative complications, and date of follow-up. Paired t-tests were used to assess mean changes in UPDRS-III. Cox proportional hazards analysis and the Kaplan-Meier method were used to determine factors associated with time to second lead insertion over 5 years.RESULTSThe final cohort included 105 patients who underwent initial unilateral DBS for asymmetrical PD; 59% of patients had a second-sided lead placed within 5 years with a median time of 34 months. Factors found to be significantly associated with early second-sided DBS included patient age 65 years or younger, globus pallidus internus (GPi) target, and greater off-medication reduction in UPDRS-III score following initial surgery. Older age was also found to be associated with a smaller preoperative UPDRS-III levodopa responsiveness score and with a smaller preoperative to postoperative medication-off UPDRS-III change.CONCLUSIONSYounger patients, those undergoing GPi-targeted unilateral DBS, and patients who responded better to the initial DBS were more likely to undergo early second-sided lead placement. Therefore, these patients, and patients who are more responsive to medication preoperatively (as a proxy for DBS responsiveness), may benefit from consideration of initial bilateral DBS.

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Pergolide Mesilate May Improve Fatigue in Patients with Parkinson’s Disease

Behavioural Neurology ◽

10.1155/2002/473140 ◽

2002 ◽

Vol 13 (3-4) ◽

pp. 117-121 ◽

Cited By ~ 19

Author(s):

Kazuo Abe ◽

Mayako Takanashi ◽

Takehiko Yanagihara ◽

Sabro Sakoda

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Dopamine Receptor ◽

Rating Scale ◽

D1 Receptor ◽

Dopamine Receptor Agonist ◽

Functional Correlation ◽

Yahr Scale ◽

Disease Rating ◽

Selective Dopamine

Objectives:Fatigue is a complaint frequently encountered among patients with Parkinson’s disease (PD). Considering the possible relationship between fatigue and dopaminergic dysfuncion, we investigated the effect of pergolide mesilate (a D2 and D1 dopamine receptor agonist) and bromocriptine (a D2 selective dopamine receptor) in patients with PD.Methods:We evaluated 41 patients with PD and controls. We assessed the degree of fatigue by using a fatigue scale. The severity of PD was evaluated by the Hoehn and Yahr Scale and the unified Parkinson’s disease rating scale (UPDRS).Results:After five weeks from prescription, patients taking pergolide mesilate showed significant improvement in the fatigue scale (from 5.1 ± 0.7 to 4.4 ± 0.55,p< 0.05, ) but patients taking bromocriptine did not (from 4.8 ± 0.9 to 4.7 ± 0.8).Conclusions:Our study suggested the possibility of functional correlation between fatigue and D1 receptor in patients with PD.

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Factors associated with depression in Parkinson’s disease: a cross-sectional study in a Polish population

European Psychiatry ◽

10.1016/j.eurpsy.2006.01.012 ◽

2006 ◽

Vol 21 (8) ◽

pp. 516-520 ◽

Cited By ~ 32

Author(s):

Hubert M. Wichowicz ◽

Jarosław Sławek ◽

Mirosława Derejko ◽

Wiesław Jerzy Cubała

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Rating Scale ◽

Structured Interview ◽

Cross Sectional Study ◽

Polish Population ◽

Cross Sectional ◽

Disability Scale ◽

Yahr Scale ◽

Specific Outcome

AbstractObjectiveThe aim of this study was to assess the prevalence and factors influencing depression in PD patients in a cross-sectional outpatient clinic - based Polish patients sample.Materials and methodsOne hundred consecutive PD patients were included in this study; 35 of them fulfilled DSM-IV criteria for Major Depression and its severity was assessed with Montgomery–Asberg Depression Rating Scale (MADRS). A structured interview and a neurological examination, including Hoehn and Yahr scale (H–Y), Schwab–England disability scale, II, III, IV parts of Unified Parkinson's Disease Rating Scale (UPDRS), and Mini-Mental State Examination (MMSE) were performed. The parameters obtained were analysed between the depressed and non-depressed PD patients.ResultsThe prevalence of depression in PD in Polish population was established at the level of 35%. PD patients with depression scored significantly higher in all UPDRS scales (except for the subscale of clinical fluctuation) and in H–Y scale. PD with depression was also associated with longer PD duration, higher doses of L-dopa equivalents, patients' age, general impairment of daily living in Schwab and England disability scale, lower MMSE and higher clinical fluctuations. However, those six differences were insignificant.ConclusionsDepression prevalence rate among PD patients in Polish population is slightly lower than in most of other published studies. This may result from strict selection criteria, use of specific outcome measures and restricted criteria for depression that were applied.

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Microelectrode-guided posteroventral medial radiofrequency pallidotomy for Parkinson's disease

Journal of Neurosurgery ◽

10.3171/jns.1997.87.1.0052 ◽

1997 ◽

Vol 87 (1) ◽

pp. 52-59 ◽

Cited By ~ 39

Author(s):

Oleg Kopyov ◽

Deane Jacques ◽

Christopher Duma ◽

Galen Buckwalter ◽

Alex Kopyov ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Side Effects ◽

Daily Living ◽

Rating Scale ◽

Target Region ◽

Content Type ◽

Significant Control ◽

Yahr Scale ◽

Disease Rating

✓ The outcome of radiofrequency-guided posteroventral medial pallidotomy was investigated in 29 patients with recalcitrant Parkinson's disease. Extracellular recordings were obtained in the target region to differentiate the internal from the external globus pallidus, and distinct waveforms were recorded in each region. Stimulation of the target site further verified the lesion location. Of the 29 patients treated during the course of 1 year, none showed any adverse side effects (such as hemianopsia or hemiparesis) from the procedure. Significant and immediate improvement in motor involvement (dyskinesia, rigidity, dystonia, freezing, and tremor) was observed as measured by the Unified Parkinson's Disease Rating Scale and the Hoehn and Yahr scale. Patients experienced improvements in their condition as measured on a self-rating scale, and their ability to perform the activities of daily living was also significantly improved. Although the onset and duration of the effect of a single dose of levodopa did not change, the number of hours in an “off” state of dyskinesia per day was significantly decreased. These results provide further evidence, in a large group of patients, that posteroventral medial pallidotomy results in significant control of the motor symptoms of Parkinson's disease with a minimum of undesirable side effects.

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Test the Best: Classification Accuracies of Four Cognitive Rating Scales for Parkinson’s Disease Mild Cognitive Impairment

Archives of Clinical Neuropsychology ◽

10.1093/arclin/acaa039 ◽

2020 ◽

Vol 35 (7) ◽

pp. 1069-1077

Author(s):

Adela Fendrych Mazancova ◽

Evžen Růžička ◽

Robert Jech ◽

Ondrej Bezdicek

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Rating Scales ◽

Rating Scale ◽

Screening Tools ◽

Cutoff Score ◽

Neuropsychological Battery ◽

Mattis Dementia Rating Scale

Abstract Objective A progressive cognitive impairment is one of the frequent non-motor symptoms during Parkinson’s disease (PD) course. A short and valid screening tool is needed to detect an incipient cognitive deficit at the mild cognitive impairment stage in Parkinson’s disease (PD–MCI). Method The present study aims to evaluate the classification accuracies of four cognitive screenings: Montreal Cognitive Assessment (MoCA), Mattis Dementia Rating Scale second edition (DRS–2), Mini-Mental State Examination (MMSE) and Frontal Assessment Battery (FAB) in a cohort of PD patients (PD–MCI, n = 46; and Parkinson’s disease with normal cognition, PD-NC, n = 95) and Controls (n = 66). All subjects underwent a standard neuropsychological battery as recommended by the International Parkinson and Movement Disorder Society and underwent all four screening tools. Results In the detection of PD-MCI versus PD-NC, the MoCA showed a sensitivity of 84% and a specificity of 66% with a screening cutoff score at ≤25 points. The MoCA’s AUC was 86% (95% CI 78.7–93.1). In the detection of PD-MCI versus Controls, the FAB displayed 84% sensitivity and 79% specificity with a cutoff ≤16 points, to screen. The FAB’s AUC was 87% (79.0–95.0). Conclusions Our results show that the MoCA is the most discriminative tool for screening MCI in the PD population.

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