| 1. |
- Friedman, Joseph H., et al.
(författare)
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Fatigue Rating Scales Critique and Recommendations by the Movement Disorders Society Task Force on Rating Scales for Parkinson's Disease
- 2010
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Ingår i: Movement Disorders. - : Wiley. - 0885-3185. ; 25:7, s. 805-822
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Forskningsöversikt (refereegranskat)abstract
- Fatigue has been shown to be a consistent and common problem in Parkinson's disease (PD) in multiple countries and cultures. It is one of the most disabling of all symptoms, including motor dysfunction, and appears early, often predating the onset of motor symptoms. Several studies of the epidemiology of fatigue have been published, often using different scales, but few on treatment. The Movement Disorder Society (MDS) commissioned a task force to assess available clinical rating scales, critique their psychometric properties, summarize their clinical properties, and evaluate the evidence in support of their use in clinical studies in PD. Six clinical researchers reviewed all studies published in peer reviewed journals of fatigue in PD, evaluated the scales' previous use, performance parameters, and quality of validation data, if available. Scales were rated according to criteria provided by the MDS. A scale was "recommended" if it has been used in clinical studies beyond the group that developed it, has been used in PD and psychometric studies have established that it is a valid, reliable and sensitive to change in people with PD. Requiring a scale to have demonstrated sensitivity to change in PD specifically rather than in other areas in order to attain a rating of "recommended" differs from the use of this term in previous MDS task force scale reviews. "Suggested" scales failed to meet all the criteria of a "recommended" scale, usually the criterion of sensitivity to change in a study of PD. Scales were "listed" if they had been used in PD studies but had little or no psychometric data to assess. Some scales could be used both to screen for fatigue as well as to assess fatigue severity, but some were only used to assess severity. The Fatigue Severity Scale was "recommended" for both screening and severity rating. The Fatigue Assessment Inventory, an expanded version of the Fatigue severity Scale, is "suggested" for both screening and severity. The Functional Assessment of Chronic Illness Therapy-Fatigue was "recommended" for screening and "suggested" for severity. The Multidimensional Fatigue Inventory was "suggested" for screening and "recommended" for severity. The Parkinson Fatigue Scale was "recommended" for screening and "suggested" for severity rating. The Fatigue Severity Inventory was "listed" for both screening and severity. The Fatigue Impact Scale for Daily Use, an adaptation of the Fatigue Impact Scale was "listed" for screening and "suggested" for severity. Visual Analogue and Global Impression Scales are both "listed" for screening and severity. The committee concluded that current scales are adequate for fatigue studies in PD but that studies on sensitivity and specificity of the scales are still needed. (C) 2010 Movement Disorder Society
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| 2. |
- Hagell, Peter, et al.
(författare)
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Clinical rating of dyskinesias in Parkinson's disease: use and reliability of a new rating scale
- 1999
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Ingår i: Movement Disorders. - 0885-3185. ; 14:3, s. 448-455
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Tidskriftsartikel (refereegranskat)abstract
- Drug-induced dyskinesias (DID) manifested as hyperkinetic and/or dystonic movements or postures are common problems in Parkinson's disease (PD). Novel therapeutic interventions may offer possibilities to counteract these common adverse effects of an otherwise necessary treatment. To be able to evaluate the effects of such interventions on DID, reliable and relevant clinical assessment tools are needed. We tested the inter- and intrarater reliability of a new clinical dyskinesia rating scale consisting of separate ratings of different body parts, including lateralization and separate ratings of dystonia and hyperkinesias. Interrater reliability was tested both with and without a defined scoring code and clarification of the dystonia section. The nondefined version was also tested for intrarater reliability. Thirteen raters independently reviewed 23 videotape sequences showing PD patients performing standardized motor tests. Inter- and intrarater agreement was significant in all evaluations, and no differences were detected when comparing ratings performed with the defined and nondefined version of the scale. The rationale for, and the role and use of, the present scale are addressed.
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| 3. |
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| 4. |
- Hagell, Peter, et al.
(författare)
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Health-related quality of life following bilateral intrastriatal transplantation in Parkinson's disease
- 2000
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Ingår i: Movement Disorders. - 0885-3185. ; 15:2, s. 224-229
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Tidskriftsartikel (refereegranskat)abstract
- Intrastriatal transplantation of embryonic dopaminergic tissue is a new, experimental approach for the treatment of Parkinson's disease (PD). Clinical trials have shown longterm graft survival and therapeutically valuable improvements with decreased L-dopa dose and time spent in the "off"-phase, and reduced rigidity and hypokinesia. We have measured health-related quality of life (HRQoL) using the Nottingham Health Profile (NHP) in five patients subjected to bilateral transplantation in the caudate and putamen to explore the influence of intrastriatal grafts on HRQoL and the value of such measures in trials of restorative therapies. The results demonstrate improved HRQoL following transplantation, with individual patients showing striking improvements within different dimensions of the NHP as well as the NHP distress index (NHPD). The most pronounced improvements after grafting were observed for physical mobility along with emotional reactions and energy. These results indicate that intrastriatal transplantation of embryonic dopaminergic tissue can give rise to improvements within most areas of HRQoL, and that HRQoL measurements provide important information additional to that obtained by traditional, symptom-oriented assessment protocols. However, the optimal approach to HRQoL measurement in PD remains to be determined.
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| 5. |
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| 6. |
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| 7. |
- Hagell, Peter, et al.
(författare)
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Pregnancy in Parkinson's disease: a review of the literature and a case report
- 1998
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Ingår i: Movement Disorders. - : Wiley. - 0885-3185 .- 1531-8257. ; 13:1, s. 34-38
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Tidskriftsartikel (refereegranskat)abstract
- Pregnancy is rare in Parkinson's disease (PD). In the literature on studies of antiparkinsonian drugs in animals during pregnancy, there are reports on malformations of the skeletal and circulatory system. However, the majority of studies in animals have not shown any teratogenicity. Amantadine has been teratogenic in rats and selegiline has caused neurochemical and behavioral alterations in rats when coadministered with clorgyline. The published experience with humans consists of 35 pregnancies among 26 women suffering from PD, including this report, and a number of cases treated with antiparkinsonian agents for other reasons. With the exception of the majority of the cases where amantadine was used, complications have been rare. However, there are indications that suggest a possible risk of a woman's parkinsonism worsening in connection with pregnancy. We also report the case of a woman with PD who was treated with L-dopa-benserazide during an uncomplicated pregnancy and gave birth to a healthy boy without experiencing any worsening of her PD.
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| 8. |
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| 9. |
- Lindholm, Beata, et al.
(författare)
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Cognitive and psychiatric symptoms are associated with walking difficulties in mild Parkinson’s disease
- 2020
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Ingår i: - : Wiley. ; , s. 549-549
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Konferensbidrag (refereegranskat)abstract
- Objective: To investigate the association of different aspects of cognitive impairment, depression and anxiety with walking difficulties in daily life in persons with mild PD.Background: Walking difficulties in daily life are common among persons with Parkinson’s disease (PD) and may cause falls and near falls, limitations in activity, restrictions in participation and decrease in quality of life. Motor symptoms are often cited as a major reason for these difficulties while the association with cognitive and psychiatric symptoms is still poorly explored.Methods: The study included cross-sectional data from 73 persons with PD that visited a neurology outpatient clinic during 2012-2017. Mean (SD) age was 69 (8.9) years, mean (SD) disease duration was 8 (4.3) years and mean (SD) “on” phase motor symptoms (Unified PD Rating Scale, UPDRS, part III) and cognition (Mini Mental State Examination, MMSE) were 16.4 (9.9) and 27.3 (2.6), respectively. Walking difficulties in daily life (the dependent variable) was investigated with the generic Walk-12 (Walk-12G). Multiple linear regression analysis (controlling for age and motor symptoms) included the following independent variables: cognition (MMSE), memory (Alzheimer's Disease Assessment Scale, ADAS, cognitive subscale), cognitive perception speed (A Quick Test of Cognitive Speed, AQT, part I-III) frontal lobe/executive impairment (Frontal Assessment Battery, FAB) and depression and anxiety (Hospital Anxiety and Depression Scale, HADS). Results: The median Walk-12G scores was 11.5 (q1-q3, 5.5−25.5). Four significant independent variables were identified explaining 15.5% of the variance in the Walk-12G score. The factor with the strongest association with walking difficulties in daily life was cognitive perception speed (AQT part I) (explaining 4.9%) closed followed by anxiety (4.9%), cognitive perception speed (AQT part II) (3%) and frontal lobe/executive impairment (2.7%). Conclusion: Cognitive and psychiatric symptoms are associated with walking difficulties in persons with mild PD. Targeting cognitive perception speed, anxiety and frontal lobe/executive impairments in PD rehabilitation may help improve walking ability in daily life.
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| 10. |
- Lindholm, Beata, et al.
(författare)
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Future falls and/or near falls in people with Parkinson’s disease: Sensitivity and specificity of two retropulsion tests
- 2013
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Ingår i: Movement Disorders. - 0885-3185. ; 28(S1), s. 163-163
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Konferensbidrag (refereegranskat)abstract
- Objective: To investigate the sensitivity and specificity of two retropulsion tests for identifying individuals with PD that will fall and/or experiencing near falls.Background: People with PD have an increased risk for falls and experiencing near falls. They are particularly unstable backwards, and different retropulsion tests exist. Item 30 of the Unified Parkinson’s Disease Rating Scale (UPDRS) is most common, involving an expected shoulder pull. Others advocate using an unexpected shoulder pull, e.g. the Nutt Retropulsion test (NRT). Methods: The study included 104 people with PD (mean age and PD-duration, 68 and 4.7 years, respectively) visiting a neurological clinic during 2006-2011. Those >80 years of age, requiring support in standing or did not understand the instructions were excluded. UPDRS and NRT assessments were conducted in the “on” condition. Participants then registered all falls and near falls by using a diary for six months. Based on this, participants were defined as “stable” (no falls/near falls) or “unstable” (≥1 fall / near fall). Sensitivity, specificity, positive and negative predictive values were calculated. Results: Mean (SD) score for UPDRS III was 14.5 (8.1). Fifty-five (53%) participants were classified as “stable” and 49 (47%) as “unstable”. Both the NRT and item 30 (UPDRS) scores differed significantly (p=0.003) between the groups. Mean NRT and item 30 scores were 0.18 (0.51) and 0.33 (0.61) for the “stable” group versus 0.63 (0.88) and 0.71 (0.74) for the “unstable” group. Sensitivity/specificity were 37%/87% (NRT), and 55%/75% (UPDRS item 30). Positive/negative predictive values were 72%/61% (NRT) and 66%/65% (UPDRS item 30).Conclusions: In this mildly affected sample, both NRT and item 30 had low sensitivity in detecting prospective falls and/or near falls over six months. Our findings speak against using either of these tests alone for this purpose and support previous recommendations of using multiple tests when targeting balance problems in people with PD.
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