Parkinsonism in multiple system atrophy: Natural history, severity (UPDRS‐III), and disability assessment compared with Parkinson's disease
Identifieur interne : 000471 ( France/Analysis ); précédent : 000470; suivant : 000472Parkinsonism in multiple system atrophy: Natural history, severity (UPDRS‐III), and disability assessment compared with Parkinson's disease
Auteurs : François Tison [France] ; Farid Yekhlef [France] ; Virginie Chrysostome [France] ; Eric Balestre [France] ; Niall P. Quinn [Royaume-Uni] ; Werner Poewe [Autriche] ; Gregor K. Wenning [Autriche]Source :
- Movement Disorders [ 0885-3185 ] ; 2002-07.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Adulte.
English descriptors
- KwdEn :
- Activities of Daily Living (classification), Adult, Aged, Antiparkinson Agents (adverse effects), Antiparkinson Agents (therapeutic use), Comparative study, Differential diagnostic, Disability, Disability Evaluation, Evaluation scale, Factor analysis, Female, Handicap, Humans, Levodopa (adverse effects), Levodopa (therapeutic use), Male, Mental Status Schedule, Middle Aged, Multiple System Atrophy (classification), Multiple System Atrophy (diagnosis), Multiple System Atrophy (drug therapy), Multiple system atrophy, Neurologic Examination (drug effects), Neurologic Examination (statistics & numerical data), Parkinson disease, Parkinson's disease, Parkinsonian Disorders (classification), Parkinsonian Disorders (diagnosis), Parkinsonian Disorders (drug therapy), Parkinsonism, Psychometrics, Reproducibility of Results, Test validation, UPDRS‐III, dependency, factor analysis, internal consistency, multiple system atrophy, parkinsonism, severity.
- MESH :
- chemical , adverse effects : Antiparkinson Agents, Levodopa.
- classification : Activities of Daily Living, Multiple System Atrophy, Parkinsonian Disorders.
- diagnosis : Multiple System Atrophy, Parkinsonian Disorders.
- drug effects : Neurologic Examination.
- drug therapy : Multiple System Atrophy, Parkinsonian Disorders.
- statistics & numerical data : Neurologic Examination.
- chemical , therapeutic use : Antiparkinson Agents, Levodopa.
- Aged, Disability Evaluation, Female, Humans, Male, Mental Status Schedule, Middle Aged, Reproducibility of Results.
Abstract
We analyzed parkinsonian features in multiple system atrophy (MSA) compared with age‐ and disease duration‐matched Parkinson's disease (PD) patients, and assessed the applicability of the Unified Parkinson's Disease Rating Scale (UPDRS) ‐III motor scale as a means of rating their severity. Cross‐sectional analysis of parkinsonism was done using UPDRS‐III, International Cerebellar Atatia Rating Scale, and disability scales (Hoehn and Yahr [H&A], Schwab and England, Katz and Lawton) in 50 unselected MSA patients and in 50 matched PD patients. At symptom onset, falls occurred 10 times more frequently in MSA, whereas limb tremor was 10 times more common in PD. At first visit (10.2 months), hemiparkinsonism and pill‐rolling rest tremor were less common in MSA. Hypomimia, atypical rest, postural or action tremor, as well as postural instability were more frequent in MSA. At study examination (62.4 months), parkinsonian signs in MSA patients were more frequently symmetrical and associated with axial rigidity, antecollis and postural instability. A levodopa response of >50% was seen in <10% of MSA patients. Modified H&Y stages (3.2 ± 1.3 vs. 2.2 ± 0.78) and UPDRS‐III scores (48.14 ± 19.5 vs. 31.74 ± 12.9) were significantly (P = 0.0001) higher in MSA. The internal consistency of the UPDRS‐III was fair in MSA patients (Cronbach's α >0.90), and correlated well with marked dependency on the Schwab and England and Katz and Lawton scales. Factor structure analysis of UPDRS‐III in MSA showed five clinically distinct subscores accounting for 74% of the variance, differing from PD by the dependency of the face–speech and limb bradykinesia items and independence of the postural–action tremor from the rest tremor items. There was a significant correlation (R2 = 0.70, P = 0.001) between ICARS ataxia and UPDRS‐III scores in MSA patients. Results confirm a distinct profile of parkinsonism in MSA and greater severity and disability compared with PD. It also indicates that the UPDRS‐III provides a useful severity measure of parkinsonism in MSA, albeit contaminated by additional cerebellar dysfunction. © 2002 Movement Disorder Society
Url:
DOI: 10.1002/mds.10171
Affiliations:
- Autriche, France, Royaume-Uni
- Angleterre, Grand Londres, Tyrol (Land)
- Bordeaux, Innsbruck, Londres
- Université de médecine d'Innsbruck
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ISTEX:1229E5C7D229E3791022ECCCACCBC9E6DC87648FLe document en format XML
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Quinn</name><affiliation wicri:level="3"><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, Queen Square, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Poewe, Werner" sort="Poewe, Werner" uniqKey="Poewe W" first="Werner" last="Poewe">Werner Poewe</name><affiliation wicri:level="1"><country xml:lang="fr">Autriche</country><wicri:regionArea>Klinik für Neurologie, University Hospital, Innsbruck</wicri:regionArea><wicri:noRegion>Innsbruck</wicri:noRegion><placeName><settlement type="city">Innsbruck</settlement><region nuts="2" type="region">Tyrol (Land)</region></placeName><orgName type="university">Université de médecine d'Innsbruck</orgName></affiliation></author><author><name sortKey="Wenning, Gregor K" sort="Wenning, Gregor K" uniqKey="Wenning G" first="Gregor K." last="Wenning">Gregor K. 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Disord.</title><idno type="ISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>New York</pubPlace><date type="published" when="2002-07">2002-07</date><biblScope unit="vol">17</biblScope><biblScope unit="issue">4</biblScope><biblScope unit="page" from="701">701</biblScope><biblScope unit="page" to="709">709</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">1229E5C7D229E3791022ECCCACCBC9E6DC87648F</idno><idno type="DOI">10.1002/mds.10171</idno><idno type="ArticleID">MDS10171</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Activities of Daily Living (classification)</term><term>Adult</term><term>Aged</term><term>Antiparkinson Agents (adverse effects)</term><term>Antiparkinson Agents (therapeutic use)</term><term>Comparative study</term><term>Differential diagnostic</term><term>Disability</term><term>Disability Evaluation</term><term>Evaluation scale</term><term>Factor analysis</term><term>Female</term><term>Handicap</term><term>Humans</term><term>Levodopa (adverse effects)</term><term>Levodopa (therapeutic use)</term><term>Male</term><term>Mental Status Schedule</term><term>Middle Aged</term><term>Multiple System Atrophy (classification)</term><term>Multiple System Atrophy (diagnosis)</term><term>Multiple System Atrophy (drug therapy)</term><term>Multiple system atrophy</term><term>Neurologic Examination (drug effects)</term><term>Neurologic Examination (statistics & numerical data)</term><term>Parkinson disease</term><term>Parkinson's disease</term><term>Parkinsonian Disorders (classification)</term><term>Parkinsonian Disorders (diagnosis)</term><term>Parkinsonian Disorders (drug therapy)</term><term>Parkinsonism</term><term>Psychometrics</term><term>Reproducibility of Results</term><term>Test validation</term><term>UPDRS‐III</term><term>dependency</term><term>factor analysis</term><term>internal consistency</term><term>multiple system atrophy</term><term>parkinsonism</term><term>severity</term></keywords><keywords scheme="MESH" type="chemical" qualifier="adverse effects" xml:lang="en"><term>Antiparkinson Agents</term><term>Levodopa</term></keywords><keywords scheme="MESH" qualifier="classification" xml:lang="en"><term>Activities of Daily Living</term><term>Multiple System Atrophy</term><term>Parkinsonian Disorders</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Multiple System Atrophy</term><term>Parkinsonian Disorders</term></keywords><keywords scheme="MESH" qualifier="drug effects" xml:lang="en"><term>Neurologic Examination</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Multiple System Atrophy</term><term>Parkinsonian Disorders</term></keywords><keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Neurologic Examination</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Antiparkinson Agents</term><term>Levodopa</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Disability Evaluation</term><term>Female</term><term>Humans</term><term>Male</term><term>Mental Status Schedule</term><term>Middle Aged</term><term>Reproducibility of Results</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Adulte</term><term>Analyse factorielle</term><term>Atrophie multisystématisée</term><term>Consistance interne</term><term>Diagnostic différentiel</term><term>Echelle évaluation</term><term>Etude comparative</term><term>Handicap</term><term>Incapacité</term><term>Parkinson maladie</term><term>Parkinsonisme</term><term>Psychométrie</term><term>Validation test</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Adulte</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">We analyzed parkinsonian features in multiple system atrophy (MSA) compared with age‐ and disease duration‐matched Parkinson's disease (PD) patients, and assessed the applicability of the Unified Parkinson's Disease Rating Scale (UPDRS) ‐III motor scale as a means of rating their severity. Cross‐sectional analysis of parkinsonism was done using UPDRS‐III, International Cerebellar Atatia Rating Scale, and disability scales (Hoehn and Yahr [H&A], Schwab and England, Katz and Lawton) in 50 unselected MSA patients and in 50 matched PD patients. At symptom onset, falls occurred 10 times more frequently in MSA, whereas limb tremor was 10 times more common in PD. At first visit (10.2 months), hemiparkinsonism and pill‐rolling rest tremor were less common in MSA. Hypomimia, atypical rest, postural or action tremor, as well as postural instability were more frequent in MSA. At study examination (62.4 months), parkinsonian signs in MSA patients were more frequently symmetrical and associated with axial rigidity, antecollis and postural instability. A levodopa response of >50% was seen in <10% of MSA patients. Modified H&Y stages (3.2 ± 1.3 vs. 2.2 ± 0.78) and UPDRS‐III scores (48.14 ± 19.5 vs. 31.74 ± 12.9) were significantly (P = 0.0001) higher in MSA. The internal consistency of the UPDRS‐III was fair in MSA patients (Cronbach's α >0.90), and correlated well with marked dependency on the Schwab and England and Katz and Lawton scales. Factor structure analysis of UPDRS‐III in MSA showed five clinically distinct subscores accounting for 74% of the variance, differing from PD by the dependency of the face–speech and limb bradykinesia items and independence of the postural–action tremor from the rest tremor items. There was a significant correlation (R2 = 0.70, P = 0.001) between ICARS ataxia and UPDRS‐III scores in MSA patients. Results confirm a distinct profile of parkinsonism in MSA and greater severity and disability compared with PD. It also indicates that the UPDRS‐III provides a useful severity measure of parkinsonism in MSA, albeit contaminated by additional cerebellar dysfunction. © 2002 Movement Disorder Society</div></front></TEI><affiliations><list><country><li>Autriche</li><li>France</li><li>Royaume-Uni</li></country><region><li>Angleterre</li><li>Grand Londres</li><li>Tyrol (Land)</li></region><settlement><li>Bordeaux</li><li>Innsbruck</li><li>Londres</li></settlement><orgName><li>Université de médecine d'Innsbruck</li></orgName></list><tree><country name="France"><noRegion><name sortKey="Tison, Francois" sort="Tison, Francois" uniqKey="Tison F" first="François" last="Tison">François Tison</name></noRegion><name sortKey="Balestre, Eric" sort="Balestre, Eric" uniqKey="Balestre E" first="Eric" last="Balestre">Eric Balestre</name><name sortKey="Chrysostome, Virginie" sort="Chrysostome, Virginie" uniqKey="Chrysostome V" first="Virginie" last="Chrysostome">Virginie Chrysostome</name><name sortKey="Yekhlef, Farid" sort="Yekhlef, Farid" uniqKey="Yekhlef F" first="Farid" last="Yekhlef">Farid Yekhlef</name></country><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Quinn, Niall P" sort="Quinn, Niall P" uniqKey="Quinn N" first="Niall P." last="Quinn">Niall P. Quinn</name></region></country><country name="Autriche"><region name="Tyrol (Land)"><name sortKey="Poewe, Werner" sort="Poewe, Werner" uniqKey="Poewe W" first="Werner" last="Poewe">Werner Poewe</name></region><name sortKey="Wenning, Gregor K" sort="Wenning, Gregor K" uniqKey="Wenning G" first="Gregor K." last="Wenning">Gregor K. Wenning</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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