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How to identify tremor dominant and postural instability/gait difficulty groups with the movement disorder society unified Parkinson's disease rating scale: Comparison with the unified Parkinson's disease rating scale

Lookup NU author(s): Professor David Burn, Dr Tien Kheng Khoo


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Background Formulas were developed to define tremor dominant (TD) and postural instability/gait difficulty (PIGD) phenotypes of Parkinson's Disease (PD) using the Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS). TD and PIGD designations, based on the original Unified Parkinson's Disease Rating Scale (UPDRS), provided useful designations for classifying different phenotypes of PD. With the advent of the MDS-UPDRS, a valid set of calculations for these phenotypes is needed. Methods UPDRS and MDS-UPDRS scores were collected on 877 PD patients. TD/PIGD scores were calculated using the UPDRS formula for all patients. Comparable TD and PIGD items from the MDS-UPDRS were used to calculate new ratios. Data were analyzed using receiver operating characteristic models. Results The new MDS-UPDRS TD/PIGD ratios accounted for a significant area under the curve compared with the UPDRS classification. Optimal sensitivity and specificity were obtained with MDS-UPDRS cutoff scores of 1.15 for TD classification and 0.90 for PIGD. Conclusions The development of comparable and valid PIGD and TD scores from the MDS-UPDRS provides a clear method for clinicians and researchers to transition from the original UPDRS to the new MDS-UPDRS in categorizing patients with different clinical phenotypes. (c) 2013 Movement Disorder Society

Publication metadata

Author(s): Stebbins GT, Goetz CG, Burn DJ, Jankovic J, Khoo TK, Tilley BC

Publication type: Article

Publication status: Published

Journal: Movement Disorders

Year: 2013

Volume: 28

Issue: 5

Pages: 668-670

Print publication date: 01/05/2013

Online publication date: 13/02/2013

Acceptance date: 04/01/2013

ISSN (print): 0885-3185

ISSN (electronic): 1531-8257

Publisher: John Wiley & Sons, Inc.


DOI: 10.1002/mds.25383


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Funder referenceFunder name
Parkinson's Disease Foundation Parkinson's Research Center
Boehringer-Ingelheim USA
Pfizer, Inc.
U01NS043127National Institute of Neurological Disorders and Stroke (NINDS)