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The association between Parkinson's disease symptom side-of-onset and performance on the MDS-UPDRS scale part IV: Motor complications.
J Neurol Sci. 2019 01 15; 396:262-265.JN

Abstract

INTRODUCTION

Parkinson's disease (PD) is a neurodegenerative condition associated with aging characterized by loss of dopamine-producing neurons in the substantia nigra pars compacta and a reduction in dopamine levels in the striatum. PD is commonly treated using dopamine-replacement medication called levodopa. Levodopa has decreasing efficacy over time. Periods when levodopa is not effective at controlling symptoms of PD are called "OFF-time" or "medication-related motor fluctuations," (MRMF). One characteristic of PD is unilateral side of symptom onset. Previous studies have found that side of onset was associated with differential motor and cognitive PD-related symptoms. The main study objective was to examine differences in left and right onset PD patients and OFF-time as measured by the Movement Disorders Society Unified Parkinson Disease Rating Scale (MDS-UPDRS) Part IV Sum Score and Part IV item scores.

METHODS

64 individuals with mild-moderate PD (age: M(SD) = 68.72 (8.88)), years with PD: M(SD) = 6.61 (5.05); Hoehn and Yahr stage Med (1st, 3rd quartile) = 2.0 (2.0, 3.0) were assessed with the MDS-UPDRS parts I-IV. We conducted two-tailed independent sample t-tests to examine the differences between PD patients with left versus right onset.

RESULTS

Right onset PD was significantly associated with more overall MRMF (p = 0.01), more OFF-time (p = 0.04), greater impact of motor fluctuations on daily life (p = 0.02) and more complex (unpredictable) MRMF (p = 0.01).

CONCLUSION

People with right onset PD have more complications with levodopa treatment. Alternative and/or adjuvant treatments to levodopa may be particularly beneficial for those with right onset PD.

Authors+Show Affiliations

Division of General Medicine and Geriatrics, Department of Medicine, Emory School of Medicine, 1648 Pierce Dr. NE, Atlanta, GA 30307, USA.Division of General Medicine and Geriatrics, Department of Medicine, Emory School of Medicine, 1648 Pierce Dr. NE, Atlanta, GA 30307, USA.Department of Environmental Health, Emory University Rollins School of Public Health, 1518 Clifton Rd., Atlanta, GA 30322, USA.Physical Therapy and Human Movement Science, Northwestern University, 633 Clark St., Evanston, IL 60208, USA.Division of General Medicine and Geriatrics, Department of Medicine, Emory School of Medicine, 1648 Pierce Dr. NE, Atlanta, GA 30307, USA; Atlanta VA Center for Visual and Neurocognitive Rehabilitation, 1670 Clairmont Rd., Decatur, GA 30033, USA; Department of Rehabilitation Medicine, Emory School of Medicine, 1648 Pierce Dr. NE, Atlanta, GA 30307, USA. Electronic address: mehackn@emory.edu.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

30537631

Citation

Bay, Allison A., et al. "The Association Between Parkinson's Disease Symptom Side-of-onset and Performance On the MDS-UPDRS Scale Part IV: Motor Complications." Journal of the Neurological Sciences, vol. 396, 2019, pp. 262-265.
Bay AA, Hart AR, Michael Caudle W, et al. The association between Parkinson's disease symptom side-of-onset and performance on the MDS-UPDRS scale part IV: Motor complications. J Neurol Sci. 2019;396:262-265.
Bay, A. A., Hart, A. R., Michael Caudle, W., Corcos, D. M., & Hackney, M. E. (2019). The association between Parkinson's disease symptom side-of-onset and performance on the MDS-UPDRS scale part IV: Motor complications. Journal of the Neurological Sciences, 396, 262-265. https://doi.org/10.1016/j.jns.2018.12.002
Bay AA, et al. The Association Between Parkinson's Disease Symptom Side-of-onset and Performance On the MDS-UPDRS Scale Part IV: Motor Complications. J Neurol Sci. 2019 01 15;396:262-265. PubMed PMID: 30537631.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The association between Parkinson's disease symptom side-of-onset and performance on the MDS-UPDRS scale part IV: Motor complications. AU - Bay,Allison A, AU - Hart,Ariel R, AU - Michael Caudle,W, AU - Corcos,Daniel M, AU - Hackney,Madeleine E, Y1 - 2018/12/04/ PY - 2018/07/19/received PY - 2018/10/18/revised PY - 2018/12/03/accepted PY - 2018/12/12/pubmed PY - 2019/7/23/medline PY - 2018/12/12/entrez KW - Levodopa KW - MDS-UPDRS KW - OFF-time KW - Parkinson's disease KW - Side-of-onset KW - Treatment SP - 262 EP - 265 JF - Journal of the neurological sciences JO - J. Neurol. Sci. VL - 396 N2 - INTRODUCTION: Parkinson's disease (PD) is a neurodegenerative condition associated with aging characterized by loss of dopamine-producing neurons in the substantia nigra pars compacta and a reduction in dopamine levels in the striatum. PD is commonly treated using dopamine-replacement medication called levodopa. Levodopa has decreasing efficacy over time. Periods when levodopa is not effective at controlling symptoms of PD are called "OFF-time" or "medication-related motor fluctuations," (MRMF). One characteristic of PD is unilateral side of symptom onset. Previous studies have found that side of onset was associated with differential motor and cognitive PD-related symptoms. The main study objective was to examine differences in left and right onset PD patients and OFF-time as measured by the Movement Disorders Society Unified Parkinson Disease Rating Scale (MDS-UPDRS) Part IV Sum Score and Part IV item scores. METHODS: 64 individuals with mild-moderate PD (age: M(SD) = 68.72 (8.88)), years with PD: M(SD) = 6.61 (5.05); Hoehn and Yahr stage Med (1st, 3rd quartile) = 2.0 (2.0, 3.0) were assessed with the MDS-UPDRS parts I-IV. We conducted two-tailed independent sample t-tests to examine the differences between PD patients with left versus right onset. RESULTS: Right onset PD was significantly associated with more overall MRMF (p = 0.01), more OFF-time (p = 0.04), greater impact of motor fluctuations on daily life (p = 0.02) and more complex (unpredictable) MRMF (p = 0.01). CONCLUSION: People with right onset PD have more complications with levodopa treatment. Alternative and/or adjuvant treatments to levodopa may be particularly beneficial for those with right onset PD. SN - 1878-5883 UR - https://www.unboundmedicine.com/medline/citation/30537631/The_association_between_Parkinson's_disease_symptom_side_of_onset_and_performance_on_the_MDS_UPDRS_scale_part_IV:_Motor_complications_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-510X(18)30488-X DB - PRIME DP - Unbound Medicine ER -