A composite clinical motor score as a comprehensive and sensitive outcome measure for Parkinson’s disease

Autor: Christine Lo, Siddharth Arora, Michael Lawton, Thomas Barber, Timothy Quinnell, Gary J Dennis, Yoav Ben-Shlomo, Michele Tao-Ming Hu
Rok vydání: 2022
Předmět:
Zdroj: Lo, C, Arora, S, Lawton, M, Barber, T, Quinnell, T, Dennis, G J, Ben-Shlomo, Y & Hu, M T-M 2022, ' A composite clinical motor score as a comprehensive and sensitive outcome measure for Parkinson's disease ', Journal of Neurology, Neurosurgery, and Psychiatry, vol. 93, no. 6, 327880, pp. 617-624 . https://doi.org/10.1136/jnnp-2021-327880
ISSN: 1468-330X
0022-3050
DOI: 10.1136/jnnp-2021-327880
Popis: BackgroundAn unmet need remains for sensitive outcome measures in neuroprotective trials. The study aims to determine whether a composite clinical motor score, combining the Movement Disorders Society-Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) III motor examination score, Purdue Pegboard Test, and Timed Up and Go, provides greater sensitivity in detecting motor change in early disease than the MDS-UPDRS III alone.MethodsThe Oxford Discovery longitudinal cohort study involves individuals with isolated rapid eye movement sleep behaviour disorder (iRBD) (n=272, confirmed polysomnographically, median follow-up: 1.6 years), idiopathic Parkinson’s disease (PD) (n=909, median follow-up: 3.5 years, baseline: ResultsCompared with the MDS-UPDRS III, the composite clinical motor score demonstrated a wider score distribution in iRBD and controls, lower coefficient of variation (37% vs 67%), and higher correlation coefficients with self-reported measures of motor severity (0.65 vs 0.61) and overall health status (−0.40 vs −0.33). Greater score range in mild to moderate PD, higher magnitude of longitudinal change in iRBD and longitudinal score linearity suggest better sensitivity in detecting subtle motor change. The composite clinical motor score was more accurate than the MDS-UPDRS III in predicting clinical outcomes, requiring 64% fewer participants with PD and 51% fewer participants with iRBD in sample size estimations for a hypothetical 18-month placebo-controlled clinical trial.ConclusionThe composite clinical motor score may offer greater consistency and sensitivity in detecting change than the MDS-UPDRS III.
Databáze: OpenAIRE
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