An Item Response Analysis of the Motor and Behavioral Subscales of the Unified Huntington's Disease Rating Scale in Huntington Disease Gene Expansion Carriers
Identifieur interne : 000716 ( PascalFrancis/Checkpoint ); précédent : 000715; suivant : 000717An Item Response Analysis of the Motor and Behavioral Subscales of the Unified Huntington's Disease Rating Scale in Huntington Disease Gene Expansion Carriers
Auteurs : Anthony L. Vaccarino [Canada] ; Karen Anderson [États-Unis] ; Beth Borowsky [États-Unis] ; Kevin Duff [États-Unis] ; Joseph Giuliano [États-Unis] ; Mark Guttman [Canada] ; Aileen K. Ho [Royaume-Uni] ; Michael Orth [Allemagne] ; Jane S. Paulsen [États-Unis] ; Terrence Sills [Canada] ; Daniel P. Van Kammen [États-Unis] ; Kenneth R. Evans [Canada]Source :
- Movement disorders [ 0885-3185 ] ; 2011.
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English descriptors
Abstract
Although the Unified Huntington's Disease Rating Scale (UHDRS) is widely used in the assessment of Huntington disease (HD), the ability of individual items to discriminate individual differences in motor or behavioral manifestations has not been extensively studied in HD gene expansion carriers without a motor-defined clinical diagnosis (ie, prodromal-HD or prHD). To elucidate the relationship between scores on individual motor and behavioral UHDRS items and total score for each subscale, a nonparametric item response analysis was performed on retrospective data from 2 multicenter longitudinal studies. Motor and behavioral assessments were supplied for 737 prHD individuals with data from 2114 visits (PREDICT-HD) and 686 HD individuals with data from 1482 visits (REGISTRY). Option characteristic curves were generated for UHDRS subscale items in relation to their subscale score. In prHD, overall severity of motor signs was low, and participants had scores of 2 or above on very few items. In HD, motor items that assessed ocular pursuit, saccade initiation, finger tapping, tandem walking, and to a lesser extent, saccade velocity, dysarthria, tongue protrusion, pronation/supination, Luria, bradykinesia, choreas, gait, and balance on the retropulsion test were found to discriminate individual differences across a broad range of motor severity. In prHD, depressed mood, anxiety, and irritable behavior demonstrated good discriminative properties. In HD, depressed mood demonstrated a good relationship with the overall behavioral score. These data suggest that at least some UHDRS items appear to have utility across a broad range of severity, although many items demonstrate problematic features.
Affiliations:
- Allemagne, Canada, Royaume-Uni, États-Unis
- Bade-Wurtemberg, District de Tübingen, Iowa, Maryland, New Jersey, Utah
- Iowa City, Ulm
- Université d'Ulm, Université de l'Iowa
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en" level="a">An Item Response Analysis of the Motor and Behavioral Subscales of the Unified Huntington's Disease Rating Scale in Huntington Disease Gene Expansion Carriers</title><author><name sortKey="Vaccarino, Anthony L" sort="Vaccarino, Anthony L" uniqKey="Vaccarino A" first="Anthony L." last="Vaccarino">Anthony L. Vaccarino</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>OCBN</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>10 aut.</sZ><sZ>12 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>OCBN</wicri:noRegion></affiliation></author><author><name sortKey="Anderson, Karen" sort="Anderson, Karen" uniqKey="Anderson K" first="Karen" last="Anderson">Karen Anderson</name><affiliation wicri:level="2"><inist:fA14 i1="02"><s1>Department of Psychiatry, University of Maryland School of Medicine</s1><s2>Baltimore, Maryland</s2><s3>USA</s3><sZ>2 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Maryland</region></placeName></affiliation></author><author><name sortKey="Borowsky, Beth" sort="Borowsky, Beth" uniqKey="Borowsky B" first="Beth" last="Borowsky">Beth Borowsky</name><affiliation wicri:level="2"><inist:fA14 i1="03"><s1>CHDI Foundation</s1><s2>Princeton, New Jersey</s2><s3>USA</s3><sZ>3 aut.</sZ><sZ>5 aut.</sZ><sZ>11 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">New Jersey</region></placeName></affiliation></author><author><name sortKey="Duff, Kevin" sort="Duff, Kevin" uniqKey="Duff K" first="Kevin" last="Duff">Kevin Duff</name><affiliation wicri:level="2"><inist:fA14 i1="04"><s1>Department of Neurology, University of Utah School of Medicine</s1><s2>Salt Lake City, Utah</s2><s3>USA</s3><sZ>4 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Utah</region></placeName></affiliation></author><author><name sortKey="Giuliano, Joseph" sort="Giuliano, Joseph" uniqKey="Giuliano J" first="Joseph" last="Giuliano">Joseph Giuliano</name><affiliation wicri:level="2"><inist:fA14 i1="03"><s1>CHDI Foundation</s1><s2>Princeton, New Jersey</s2><s3>USA</s3><sZ>3 aut.</sZ><sZ>5 aut.</sZ><sZ>11 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">New Jersey</region></placeName></affiliation></author><author><name sortKey="Guttman, Mark" sort="Guttman, Mark" uniqKey="Guttman M" first="Mark" last="Guttman">Mark Guttman</name><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>The Center for Movement Disorders</s1><s2>Markham, Ontario</s2><s3>CAN</s3><sZ>6 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>The Center for Movement Disorders</wicri:noRegion></affiliation></author><author><name sortKey="Ho, Aileen K" sort="Ho, Aileen K" uniqKey="Ho A" first="Aileen K." last="Ho">Aileen K. Ho</name><affiliation wicri:level="1"><inist:fA14 i1="06"><s1>School of Psychology and Clinical Language Sciences, University of Reading</s1><s2>Reading</s2><s3>GBR</s3><sZ>7 aut.</sZ></inist:fA14><country>Royaume-Uni</country><wicri:noRegion>Reading</wicri:noRegion></affiliation></author><author><name sortKey="Orth, Michael" sort="Orth, Michael" uniqKey="Orth M" first="Michael" last="Orth">Michael Orth</name><affiliation wicri:level="4"><inist:fA14 i1="07"><s1>European Huntington's Disease Network, University of Ulm</s1><s2>Ulm</s2><s3>DEU</s3><sZ>8 aut.</sZ></inist:fA14><country>Allemagne</country><placeName><region type="land" nuts="1">Bade-Wurtemberg</region><region type="district" nuts="2">District de Tübingen</region><settlement type="city">Ulm</settlement></placeName><orgName type="university">Université d'Ulm</orgName></affiliation></author><author><name sortKey="Paulsen, Jane S" sort="Paulsen, Jane S" uniqKey="Paulsen J" first="Jane S." last="Paulsen">Jane S. Paulsen</name><affiliation wicri:level="4"><inist:fA14 i1="08"><s1>Department of Psychiatry, University of Iowa</s1><s2>Iowa City, Iowa</s2><s3>USA</s3><sZ>9 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Iowa</region><settlement type="city">Iowa City</settlement></placeName><orgName type="university">Université de l'Iowa</orgName></affiliation></author><author><name sortKey="Sills, Terrence" sort="Sills, Terrence" uniqKey="Sills T" first="Terrence" last="Sills">Terrence Sills</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>OCBN</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>10 aut.</sZ><sZ>12 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>OCBN</wicri:noRegion></affiliation></author><author><name sortKey="Van Kammen, Daniel P" sort="Van Kammen, Daniel P" uniqKey="Van Kammen D" first="Daniel P." last="Van Kammen">Daniel P. Van Kammen</name><affiliation wicri:level="2"><inist:fA14 i1="03"><s1>CHDI Foundation</s1><s2>Princeton, New Jersey</s2><s3>USA</s3><sZ>3 aut.</sZ><sZ>5 aut.</sZ><sZ>11 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">New Jersey</region></placeName></affiliation></author><author><name sortKey="Evans, Kenneth R" sort="Evans, Kenneth R" uniqKey="Evans K" first="Kenneth R." last="Evans">Kenneth R. Evans</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>OCBN</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>10 aut.</sZ><sZ>12 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>OCBN</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">11-0228441</idno><date when="2011">2011</date><idno type="stanalyst">PASCAL 11-0228441 INIST</idno><idno type="RBID">Pascal:11-0228441</idno><idno type="wicri:Area/PascalFrancis/Corpus">000605</idno><idno type="wicri:Area/PascalFrancis/Curation">002713</idno><idno type="wicri:Area/PascalFrancis/Checkpoint">000716</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">An Item Response Analysis of the Motor and Behavioral Subscales of the Unified Huntington's Disease Rating Scale in Huntington Disease Gene Expansion Carriers</title><author><name sortKey="Vaccarino, Anthony L" sort="Vaccarino, Anthony L" uniqKey="Vaccarino A" first="Anthony L." last="Vaccarino">Anthony L. Vaccarino</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>OCBN</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>10 aut.</sZ><sZ>12 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>OCBN</wicri:noRegion></affiliation></author><author><name sortKey="Anderson, Karen" sort="Anderson, Karen" uniqKey="Anderson K" first="Karen" last="Anderson">Karen Anderson</name><affiliation wicri:level="2"><inist:fA14 i1="02"><s1>Department of Psychiatry, University of Maryland School of Medicine</s1><s2>Baltimore, Maryland</s2><s3>USA</s3><sZ>2 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Maryland</region></placeName></affiliation></author><author><name sortKey="Borowsky, Beth" sort="Borowsky, Beth" uniqKey="Borowsky B" first="Beth" last="Borowsky">Beth Borowsky</name><affiliation wicri:level="2"><inist:fA14 i1="03"><s1>CHDI Foundation</s1><s2>Princeton, New Jersey</s2><s3>USA</s3><sZ>3 aut.</sZ><sZ>5 aut.</sZ><sZ>11 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">New Jersey</region></placeName></affiliation></author><author><name sortKey="Duff, Kevin" sort="Duff, Kevin" uniqKey="Duff K" first="Kevin" last="Duff">Kevin Duff</name><affiliation wicri:level="2"><inist:fA14 i1="04"><s1>Department of Neurology, University of Utah School of Medicine</s1><s2>Salt Lake City, Utah</s2><s3>USA</s3><sZ>4 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Utah</region></placeName></affiliation></author><author><name sortKey="Giuliano, Joseph" sort="Giuliano, Joseph" uniqKey="Giuliano J" first="Joseph" last="Giuliano">Joseph Giuliano</name><affiliation wicri:level="2"><inist:fA14 i1="03"><s1>CHDI Foundation</s1><s2>Princeton, New Jersey</s2><s3>USA</s3><sZ>3 aut.</sZ><sZ>5 aut.</sZ><sZ>11 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">New Jersey</region></placeName></affiliation></author><author><name sortKey="Guttman, Mark" sort="Guttman, Mark" uniqKey="Guttman M" first="Mark" last="Guttman">Mark Guttman</name><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>The Center for Movement Disorders</s1><s2>Markham, Ontario</s2><s3>CAN</s3><sZ>6 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>The Center for Movement Disorders</wicri:noRegion></affiliation></author><author><name sortKey="Ho, Aileen K" sort="Ho, Aileen K" uniqKey="Ho A" first="Aileen K." last="Ho">Aileen K. Ho</name><affiliation wicri:level="1"><inist:fA14 i1="06"><s1>School of Psychology and Clinical Language Sciences, University of Reading</s1><s2>Reading</s2><s3>GBR</s3><sZ>7 aut.</sZ></inist:fA14><country>Royaume-Uni</country><wicri:noRegion>Reading</wicri:noRegion></affiliation></author><author><name sortKey="Orth, Michael" sort="Orth, Michael" uniqKey="Orth M" first="Michael" last="Orth">Michael Orth</name><affiliation wicri:level="4"><inist:fA14 i1="07"><s1>European Huntington's Disease Network, University of Ulm</s1><s2>Ulm</s2><s3>DEU</s3><sZ>8 aut.</sZ></inist:fA14><country>Allemagne</country><placeName><region type="land" nuts="1">Bade-Wurtemberg</region><region type="district" nuts="2">District de Tübingen</region><settlement type="city">Ulm</settlement></placeName><orgName type="university">Université d'Ulm</orgName></affiliation></author><author><name sortKey="Paulsen, Jane S" sort="Paulsen, Jane S" uniqKey="Paulsen J" first="Jane S." last="Paulsen">Jane S. Paulsen</name><affiliation wicri:level="4"><inist:fA14 i1="08"><s1>Department of Psychiatry, University of Iowa</s1><s2>Iowa City, Iowa</s2><s3>USA</s3><sZ>9 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Iowa</region><settlement type="city">Iowa City</settlement></placeName><orgName type="university">Université de l'Iowa</orgName></affiliation></author><author><name sortKey="Sills, Terrence" sort="Sills, Terrence" uniqKey="Sills T" first="Terrence" last="Sills">Terrence Sills</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>OCBN</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>10 aut.</sZ><sZ>12 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>OCBN</wicri:noRegion></affiliation></author><author><name sortKey="Van Kammen, Daniel P" sort="Van Kammen, Daniel P" uniqKey="Van Kammen D" first="Daniel P." last="Van Kammen">Daniel P. Van Kammen</name><affiliation wicri:level="2"><inist:fA14 i1="03"><s1>CHDI Foundation</s1><s2>Princeton, New Jersey</s2><s3>USA</s3><sZ>3 aut.</sZ><sZ>5 aut.</sZ><sZ>11 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">New Jersey</region></placeName></affiliation></author><author><name sortKey="Evans, Kenneth R" sort="Evans, Kenneth R" uniqKey="Evans K" first="Kenneth R." last="Evans">Kenneth R. Evans</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>OCBN</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>10 aut.</sZ><sZ>12 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>OCBN</wicri:noRegion></affiliation></author></analytic><series><title level="j" type="main">Movement disorders</title><title level="j" type="abbreviated">Mov. disord.</title><idno type="ISSN">0885-3185</idno><imprint><date when="2011">2011</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Movement disorders</title><title level="j" type="abbreviated">Mov. disord.</title><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Carrier</term><term>Evaluation scale</term><term>Huntington disease</term><term>Nervous system diseases</term><term>Theory</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Chorée de Huntington</term><term>Pathologie du système nerveux</term><term>Echelle d'évaluation</term><term>Porteur</term><term>Théorie</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Although the Unified Huntington's Disease Rating Scale (UHDRS) is widely used in the assessment of Huntington disease (HD), the ability of individual items to discriminate individual differences in motor or behavioral manifestations has not been extensively studied in HD gene expansion carriers without a motor-defined clinical diagnosis (ie, prodromal-HD or prHD). To elucidate the relationship between scores on individual motor and behavioral UHDRS items and total score for each subscale, a nonparametric item response analysis was performed on retrospective data from 2 multicenter longitudinal studies. Motor and behavioral assessments were supplied for 737 prHD individuals with data from 2114 visits (PREDICT-HD) and 686 HD individuals with data from 1482 visits (REGISTRY). Option characteristic curves were generated for UHDRS subscale items in relation to their subscale score. In prHD, overall severity of motor signs was low, and participants had scores of 2 or above on very few items. In HD, motor items that assessed ocular pursuit, saccade initiation, finger tapping, tandem walking, and to a lesser extent, saccade velocity, dysarthria, tongue protrusion, pronation/supination, Luria, bradykinesia, choreas, gait, and balance on the retropulsion test were found to discriminate individual differences across a broad range of motor severity. In prHD, depressed mood, anxiety, and irritable behavior demonstrated good discriminative properties. In HD, depressed mood demonstrated a good relationship with the overall behavioral score. These data suggest that at least some UHDRS items appear to have utility across a broad range of severity, although many items demonstrate problematic features.</div></front></TEI><inist><standard h6="B"><pA><fA01 i1="01" i2="1"><s0>0885-3185</s0></fA01><fA03 i2="1"><s0>Mov. disord.</s0></fA03><fA05><s2>26</s2></fA05><fA06><s2>5</s2></fA06><fA08 i1="01" i2="1" l="ENG"><s1>An Item Response Analysis of the Motor and Behavioral Subscales of the Unified Huntington's Disease Rating Scale in Huntington Disease Gene Expansion Carriers</s1></fA08><fA11 i1="01" i2="1"><s1>VACCARINO (Anthony L.)</s1></fA11><fA11 i1="02" i2="1"><s1>ANDERSON (Karen)</s1></fA11><fA11 i1="03" i2="1"><s1>BOROWSKY (Beth)</s1></fA11><fA11 i1="04" i2="1"><s1>DUFF (Kevin)</s1></fA11><fA11 i1="05" i2="1"><s1>GIULIANO (Joseph)</s1></fA11><fA11 i1="06" i2="1"><s1>GUTTMAN (Mark)</s1></fA11><fA11 i1="07" i2="1"><s1>HO (Aileen K.)</s1></fA11><fA11 i1="08" i2="1"><s1>ORTH (Michael)</s1></fA11><fA11 i1="09" i2="1"><s1>PAULSEN (Jane S.)</s1></fA11><fA11 i1="10" i2="1"><s1>SILLS (Terrence)</s1></fA11><fA11 i1="11" i2="1"><s1>VAN KAMMEN (Daniel P.)</s1></fA11><fA11 i1="12" i2="1"><s1>EVANS (Kenneth R.)</s1></fA11><fA14 i1="01"><s1>OCBN</s1><s2>Toronto, Ontario</s2><s3>CAN</s3><sZ>1 aut.</sZ><sZ>10 aut.</sZ><sZ>12 aut.</sZ></fA14><fA14 i1="02"><s1>Department of Psychiatry, University of Maryland School of Medicine</s1><s2>Baltimore, Maryland</s2><s3>USA</s3><sZ>2 aut.</sZ></fA14><fA14 i1="03"><s1>CHDI Foundation</s1><s2>Princeton, New Jersey</s2><s3>USA</s3><sZ>3 aut.</sZ><sZ>5 aut.</sZ><sZ>11 aut.</sZ></fA14><fA14 i1="04"><s1>Department of Neurology, University of Utah School of Medicine</s1><s2>Salt Lake City, Utah</s2><s3>USA</s3><sZ>4 aut.</sZ></fA14><fA14 i1="05"><s1>The Center for Movement Disorders</s1><s2>Markham, Ontario</s2><s3>CAN</s3><sZ>6 aut.</sZ></fA14><fA14 i1="06"><s1>School of Psychology and Clinical Language Sciences, University of Reading</s1><s2>Reading</s2><s3>GBR</s3><sZ>7 aut.</sZ></fA14><fA14 i1="07"><s1>European Huntington's Disease Network, University of Ulm</s1><s2>Ulm</s2><s3>DEU</s3><sZ>8 aut.</sZ></fA14><fA14 i1="08"><s1>Department of Psychiatry, University of Iowa</s1><s2>Iowa City, Iowa</s2><s3>USA</s3><sZ>9 aut.</sZ></fA14><fA20><s1>877-884</s1></fA20><fA21><s1>2011</s1></fA21><fA23 i1="01"><s0>ENG</s0></fA23><fA43 i1="01"><s1>INIST</s1><s2>20953</s2><s5>354000189767620170</s5></fA43><fA44><s0>0000</s0><s1>© 2011 INIST-CNRS. All rights reserved.</s1></fA44><fA45><s0>35 ref.</s0></fA45><fA47 i1="01" i2="1"><s0>11-0228441</s0></fA47><fA60><s1>P</s1></fA60><fA61><s0>A</s0></fA61><fA64 i1="01" i2="1"><s0>Movement disorders</s0></fA64><fA66 i1="01"><s0>USA</s0></fA66><fC01 i1="01" l="ENG"><s0>Although the Unified Huntington's Disease Rating Scale (UHDRS) is widely used in the assessment of Huntington disease (HD), the ability of individual items to discriminate individual differences in motor or behavioral manifestations has not been extensively studied in HD gene expansion carriers without a motor-defined clinical diagnosis (ie, prodromal-HD or prHD). To elucidate the relationship between scores on individual motor and behavioral UHDRS items and total score for each subscale, a nonparametric item response analysis was performed on retrospective data from 2 multicenter longitudinal studies. Motor and behavioral assessments were supplied for 737 prHD individuals with data from 2114 visits (PREDICT-HD) and 686 HD individuals with data from 1482 visits (REGISTRY). Option characteristic curves were generated for UHDRS subscale items in relation to their subscale score. In prHD, overall severity of motor signs was low, and participants had scores of 2 or above on very few items. In HD, motor items that assessed ocular pursuit, saccade initiation, finger tapping, tandem walking, and to a lesser extent, saccade velocity, dysarthria, tongue protrusion, pronation/supination, Luria, bradykinesia, choreas, gait, and balance on the retropulsion test were found to discriminate individual differences across a broad range of motor severity. In prHD, depressed mood, anxiety, and irritable behavior demonstrated good discriminative properties. In HD, depressed mood demonstrated a good relationship with the overall behavioral score. These data suggest that at least some UHDRS items appear to have utility across a broad range of severity, although many items demonstrate problematic features.</s0></fC01><fC02 i1="01" i2="X"><s0>002B17</s0></fC02><fC02 i1="02" i2="X"><s0>002B17G</s0></fC02><fC03 i1="01" i2="X" l="FRE"><s0>Chorée de Huntington</s0><s5>01</s5></fC03><fC03 i1="01" i2="X" l="ENG"><s0>Huntington disease</s0><s5>01</s5></fC03><fC03 i1="01" i2="X" l="SPA"><s0>Corea Huntington</s0><s5>01</s5></fC03><fC03 i1="02" i2="X" l="FRE"><s0>Pathologie du système nerveux</s0><s5>02</s5></fC03><fC03 i1="02" i2="X" l="ENG"><s0>Nervous system diseases</s0><s5>02</s5></fC03><fC03 i1="02" i2="X" l="SPA"><s0>Sistema nervioso patología</s0><s5>02</s5></fC03><fC03 i1="03" i2="X" l="FRE"><s0>Echelle d'évaluation</s0><s5>09</s5></fC03><fC03 i1="03" i2="X" l="ENG"><s0>Evaluation scale</s0><s5>09</s5></fC03><fC03 i1="03" i2="X" l="SPA"><s0>Escala evaluación</s0><s5>09</s5></fC03><fC03 i1="04" i2="X" l="FRE"><s0>Porteur</s0><s5>10</s5></fC03><fC03 i1="04" i2="X" l="ENG"><s0>Carrier</s0><s5>10</s5></fC03><fC03 i1="04" i2="X" l="SPA"><s0>Portador</s0><s5>10</s5></fC03><fC03 i1="05" i2="X" l="FRE"><s0>Théorie</s0><s5>11</s5></fC03><fC03 i1="05" i2="X" l="ENG"><s0>Theory</s0><s5>11</s5></fC03><fC03 i1="05" i2="X" l="SPA"><s0>Teoría</s0><s5>11</s5></fC03><fC07 i1="01" i2="X" l="FRE"><s0>Pathologie de l'encéphale</s0><s5>37</s5></fC07><fC07 i1="01" i2="X" l="ENG"><s0>Cerebral disorder</s0><s5>37</s5></fC07><fC07 i1="01" i2="X" l="SPA"><s0>Encéfalo patología</s0><s5>37</s5></fC07><fC07 i1="02" i2="X" l="FRE"><s0>Syndrome extrapyramidal</s0><s5>38</s5></fC07><fC07 i1="02" i2="X" l="ENG"><s0>Extrapyramidal syndrome</s0><s5>38</s5></fC07><fC07 i1="02" i2="X" l="SPA"><s0>Extrapiramidal síndrome</s0><s5>38</s5></fC07><fC07 i1="03" i2="X" l="FRE"><s0>Maladie dégénérative</s0><s5>39</s5></fC07><fC07 i1="03" i2="X" l="ENG"><s0>Degenerative disease</s0><s5>39</s5></fC07><fC07 i1="03" i2="X" l="SPA"><s0>Enfermedad degenerativa</s0><s5>39</s5></fC07><fC07 i1="04" i2="X" l="FRE"><s0>Maladie héréditaire</s0><s5>40</s5></fC07><fC07 i1="04" i2="X" l="ENG"><s0>Genetic disease</s0><s5>40</s5></fC07><fC07 i1="04" i2="X" l="SPA"><s0>Enfermedad hereditaria</s0><s5>40</s5></fC07><fC07 i1="05" i2="X" l="FRE"><s0>Pathologie du système nerveux central</s0><s5>41</s5></fC07><fC07 i1="05" i2="X" l="ENG"><s0>Central nervous system disease</s0><s5>41</s5></fC07><fC07 i1="05" i2="X" l="SPA"><s0>Sistema nervosio central patología</s0><s5>41</s5></fC07><fN21><s1>150</s1></fN21><fN44 i1="01"><s1>OTO</s1></fN44><fN82><s1>OTO</s1></fN82></pA></standard></inist><affiliations><list><country><li>Allemagne</li><li>Canada</li><li>Royaume-Uni</li><li>États-Unis</li></country><region><li>Bade-Wurtemberg</li><li>District de Tübingen</li><li>Iowa</li><li>Maryland</li><li>New Jersey</li><li>Utah</li></region><settlement><li>Iowa City</li><li>Ulm</li></settlement><orgName><li>Université d'Ulm</li><li>Université de l'Iowa</li></orgName></list><tree><country name="Canada"><noRegion><name sortKey="Vaccarino, Anthony L" sort="Vaccarino, Anthony L" uniqKey="Vaccarino A" first="Anthony L." last="Vaccarino">Anthony L. Vaccarino</name></noRegion><name sortKey="Evans, Kenneth R" sort="Evans, Kenneth R" uniqKey="Evans K" first="Kenneth R." last="Evans">Kenneth R. Evans</name><name sortKey="Guttman, Mark" sort="Guttman, Mark" uniqKey="Guttman M" first="Mark" last="Guttman">Mark Guttman</name><name sortKey="Sills, Terrence" sort="Sills, Terrence" uniqKey="Sills T" first="Terrence" last="Sills">Terrence Sills</name></country><country name="États-Unis"><region name="Maryland"><name sortKey="Anderson, Karen" sort="Anderson, Karen" uniqKey="Anderson K" first="Karen" last="Anderson">Karen Anderson</name></region><name sortKey="Borowsky, Beth" sort="Borowsky, Beth" uniqKey="Borowsky B" first="Beth" last="Borowsky">Beth Borowsky</name><name sortKey="Duff, Kevin" sort="Duff, Kevin" uniqKey="Duff K" first="Kevin" last="Duff">Kevin Duff</name><name sortKey="Giuliano, Joseph" sort="Giuliano, Joseph" uniqKey="Giuliano J" first="Joseph" last="Giuliano">Joseph Giuliano</name><name sortKey="Paulsen, Jane S" sort="Paulsen, Jane S" uniqKey="Paulsen J" first="Jane S." last="Paulsen">Jane S. Paulsen</name><name sortKey="Van Kammen, Daniel P" sort="Van Kammen, Daniel P" uniqKey="Van Kammen D" first="Daniel P." last="Van Kammen">Daniel P. Van Kammen</name></country><country name="Royaume-Uni"><noRegion><name sortKey="Ho, Aileen K" sort="Ho, Aileen K" uniqKey="Ho A" first="Aileen K." last="Ho">Aileen K. Ho</name></noRegion></country><country name="Allemagne"><region name="Bade-Wurtemberg"><name sortKey="Orth, Michael" sort="Orth, Michael" uniqKey="Orth M" first="Michael" last="Orth">Michael Orth</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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