The Unified Parkinson's Disease Rating Scale (UPDRS): Status and recommendations

Movement Disorders - Tập 18 Số 7 - Trang 738-750 - 2003

Tóm tắt

AbstractThe Movement Disorder Society Task Force for Rating Scales for Parkinson's Disease prepared a critique of the Unified Parkinson's Disease Rating Scale (UPDRS). Strengths of the UPDRS include its wide utilization, its application across the clinical spectrum of PD, its nearly comprehensive coverage of motor symptoms, and its clinimetric properties, including reliability and validity. Weaknesses include several ambiguities in the written text, inadequate instructions for raters, some metric flaws, and the absence of screening questions on several important non‐motor aspects of PD. The Task Force recommends that the MDS sponsor the development of a new version of the UPDRS and encourage efforts to establish its clinimetric properties, especially addressing the need to define a Minimal Clinically Relevant Difference and a Minimal Clinically Relevant Incremental Difference, as well as testing its correlation with the current UPDRS. If developed, the new scale should be culturally unbiased and be tested in different racial, gender, and age‐groups. Future goals should include the definition of UPDRS scores with confidence intervals that correlate with clinically pertinent designations, “minimal,” “mild,” “moderate,” and “severe” PD. Whereas the presence of non‐motor components of PD can be identified with screening questions, a new version of the UPDRS should include an official appendix that includes other, more detailed, and optionally used scales to determine severity of these impairments. © 2003 Movement Disorder Society

Từ khóa


Tài liệu tham khảo

Fahn S, 1987, 153

Webster DD, 1968, Critical analysis of the disability in Parkinson's disease, Mod Treat, 5, 257

Duvoisin RC, 1971, Monoamines noyaux gris centraux et syndrome de Parkinson

10.1016/S0140-6736(70)90634-3

10.1097/00005053-196108000-00010

Lieberman A, 1973, 415

10.1002/ana.410030314

Schwab JF, 1968, Third Symposium on Parkinson's Disease, 152

10.1212/WNL.17.5.427

10.1002/mds.10248

10.1159/000026244

10.1002/mds.870100305

10.1002/mds.870090112

10.1002/mds.870110212

10.1212/WNL.49.6.1580

10.1093/brain/119.2.585

10.1002/ana.410380407

10.1097/00002826-199708000-00004

10.1016/S1353-8020(99)00023-1

10.1097/00002826-199706000-00001

Committee for proprietary medicinal products. Guidance on clinical investigation of medicinal products in the treatment of Parkinson's disease.2002. Online athttp://www.emea.eu.int/pdfs/human/ewp/056395en.pdf.

10.1002/mds.10024

10.1002/mds.870070103

10.1002/1531-8257(199907)14:4<572::AID-MDS1005>3.0.CO;2-C

10.1002/1531-8257(200003)15:2<276::AID-MDS1010>3.0.CO;2-Q

10.1111/j.1600-0404.1997.tb00299.x

10.1056/NEJM199301213280305

10.1212/WNL.49.1.162

10.1007/BF01273184

10.1002/mds.870090114

10.1001/archneur.1995.00540300037010

10.1212/WNL.47.6_Suppl_3.146S

Oakes D, 1990, Progression of early Parkinson's disease until levodopa therapy is required, Neurology, 40, 370

10.1016/S0140-6736(02)08520-3

10.1212/WNL.49.2.393

Tanner CM, 1999, Pramipexole in ethnic minority with Parkinson's disease, Mov Disord, 14, 901

10.1002/mds.870090113

10.1002/mds.870130404

10.1002/1531-8257(199907)14:4<585::AID-MDS1006>3.0.CO;2-3

10.1002/1531-8257(200101)16:1<33::AID-MDS1014>3.0.CO;2-W

10.1002/mds.10011

Martinez‐Martin P, 2000, Parkinson's disease: quantification of disability based on the Unified Parkinson's disease Rating Scale, Neurologia, 15, 382

10.1016/S0196-0644(96)70238-X

10.1067/mem.2001.118863

10.1067/mem.2001.118012

10.1183/09031936.02.00063702

10.1016/S0304-3959(99)00081-0

10.1016/S0006-3223(00)00839-8

10.1177/089198870001300404

10.1212/WNL.44.12.2315

10.1016/S0140-6736(99)03556-4

Oertel WH, 2000, Pergolide versus levodopa monotherapy (PELMOPET), Mov Disord, 15, 4

10.1056/NEJM199903113401003

10.1212/WNL.55.6.789

Giladi N, 2001, The effect of treatment with rivastigmin (Exelon) on cognitive functions of patients with dementia and Parkinson's disease, Neurology, 56, A128

10.1002/mds.870070204

10.1002/mds.870090103

Goetz CG, 1999, Rating scales for dyskinesias in Parkinson's disease, Mov Disord, 14, 48

10.1002/mds.870120106

Lang AE, 1996, Teaching tape for the motor section of the Unified Parkinson's Disease Rating Scale, Mov Disord, 11, 344

10.1136/jnnp.72.2.241

Martinez‐Martin P, 1993, Parkinson's disease and movement disorders, 281