The Movement Disorders Task Force Review of Dysautonomia Rating Scales in Parkinson's Disease with Regard to Symptoms of Orthostatic Hypotension
Identifieur interne : 002898 ( PascalFrancis/Curation ); précédent : 002897; suivant : 002899The Movement Disorders Task Force Review of Dysautonomia Rating Scales in Parkinson's Disease with Regard to Symptoms of Orthostatic Hypotension
Auteurs : Anne Pavy-Le Traon [France] ; Gerard Amarenco [France] ; Susanne Duerr [Autriche] ; Horacio Kaufmann [États-Unis] ; Heinz Lahrmann [Autriche] ; Stephanie R. Shaftman [États-Unis] ; François Tison [France] ; Gregor K. Wenning [Autriche] ; Christopher G. Goetz [États-Unis] ; Werner Poewe [Autriche] ; Cristina Sampaio [Portugal] ; Anette Schrag [Royaume-Uni] ; Glenn T. Stebbins [États-Unis] ; Olivier Rascol [France]Source :
- Movement disorders [ 0885-3185 ] ; 2011.
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- Pascal (Inist)
English descriptors
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Abstract
Orthostatic hypotension is defined as a blood pressure fall of > 20 mm Hg systolic and/or 10 mm Hg diastolic within 3 minutes of an upright position. The Movement Disorders Society commissioned a task force to assess existing clinical rating scales addressing symptoms of orthostatic hypotension in Parkinson's disease. Seven neurologists and a clinimetrician assessed each scale's previous use and critiqued its clinimetric properties. A scale was "recommended" if it had been applied to populations of patients with Parkinson's disease, with data on its use in studies beyond the group that developed the scale, and was found to be clinimetrically valid. A scale was considered "suggested" if it had been applied to Parkinson's disease, but only 1 of the other criteria was applied. A scale was "listed" if it met only 1 criterion. Symptoms of orthostatic hypotension are generally assessed in scales on wider autonomic or nonmotor symptoms. Some scales designed to detect orthostatic hypotension-related symptoms provide information on their severity: the AUTonomic SCale for Outcomes in PArkinson's Disease and the COMPosite Autonomic Symptom Scale met criteria for recommended with some limitations; the Novel Non-Motor Symptoms Scale and the Orthostatic Grading Scale were classified as suggested. The Self-completed Non-Motor Symptoms Questionnaire for Parkinson's Disease was classified as suggested as a tool for screening orthostatic symptoms. However, these and the listed scales need further validation and application before they can be recommended for clinical use in patients with Parkinson's disease.
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Stebbins</name><affiliation wicri:level="1"><inist:fA14 i1="09"><s1>Department of Neurological Services, Rush University School of Medicine</s1><s2>Chicago, Illinois</s2><s3>USA</s3><sZ>9 aut.</sZ><sZ>13 aut.</sZ></inist:fA14><country>États-Unis</country></affiliation></author><author><name sortKey="Rascol, Olivier" sort="Rascol, Olivier" uniqKey="Rascol O" first="Olivier" last="Rascol">Olivier Rascol</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Reference Centre for MSA, University Hospital, INSERM U1048 Eq8</s1><s2>Toulouse</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>7 aut.</sZ><sZ>14 aut.</sZ></inist:fA14><country>France</country></affiliation><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Explorations Fonctionnelles, University Hospital</s1><s2>Brest</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>7 aut.</sZ><sZ>14 aut.</sZ></inist:fA14><country>France</country></affiliation><affiliation wicri:level="1"><inist:fA14 i1="13"><s1>Department of Clinical Pharmacology and Clinical Investigation Center, University Hospital and University of Toulouse III</s1><s2>Toulouse</s2><s3>FRA</s3><sZ>14 aut.</sZ></inist:fA14><country>France</country></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">11-0444600</idno><date when="2011">2011</date><idno type="stanalyst">PASCAL 11-0444600 INIST</idno><idno type="RBID">Pascal:11-0444600</idno><idno type="wicri:Area/PascalFrancis/Corpus">000420</idno><idno type="wicri:Area/PascalFrancis/Curation">002898</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">The Movement Disorders Task Force Review of Dysautonomia Rating Scales in Parkinson's Disease with Regard to Symptoms of Orthostatic Hypotension</title><author><name sortKey="Pavy Le Traon, Anne" sort="Pavy Le Traon, Anne" uniqKey="Pavy Le Traon A" first="Anne" last="Pavy-Le Traon">Anne Pavy-Le Traon</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Reference Centre for MSA, University Hospital, INSERM U1048 Eq8</s1><s2>Toulouse</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>7 aut.</sZ><sZ>14 aut.</sZ></inist:fA14><country>France</country></affiliation><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Explorations Fonctionnelles, University Hospital</s1><s2>Brest</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>7 aut.</sZ><sZ>14 aut.</sZ></inist:fA14><country>France</country></affiliation></author><author><name sortKey="Amarenco, Gerard" sort="Amarenco, Gerard" uniqKey="Amarenco G" first="Gerard" last="Amarenco">Gerard Amarenco</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Service de Rééducation Neurologique et d'Explorations Périnéales, Rothschild Hospital</s1><s2>Paris</s2><s3>FRA</s3><sZ>2 aut.</sZ></inist:fA14><country>France</country></affiliation></author><author><name sortKey="Duerr, Susanne" sort="Duerr, Susanne" uniqKey="Duerr S" first="Susanne" last="Duerr">Susanne Duerr</name><affiliation wicri:level="1"><inist:fA14 i1="04"><s1>Division of Clinical Neurobiology, Medical University</s1><s2>Innsbruck</s2><s3>AUT</s3><sZ>3 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>Autriche</country></affiliation></author><author><name sortKey="Kaufmann, Horacio" sort="Kaufmann, Horacio" uniqKey="Kaufmann H" first="Horacio" last="Kaufmann">Horacio Kaufmann</name><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Department of Neurology, New York University, New York</s1><s2>New York</s2><s3>USA</s3><sZ>4 aut.</sZ></inist:fA14><country>États-Unis</country></affiliation></author><author><name sortKey="Lahrmann, Heinz" sort="Lahrmann, Heinz" uniqKey="Lahrmann H" first="Heinz" last="Lahrmann">Heinz Lahrmann</name><affiliation wicri:level="1"><inist:fA14 i1="06"><s1>Department of Neurology, Kaiser Franz Josef Hospital</s1><s2>Vienna</s2><s3>AUT</s3><sZ>5 aut.</sZ></inist:fA14><country>Autriche</country></affiliation></author><author><name sortKey="Shaftman, Stephanie R" sort="Shaftman, Stephanie R" uniqKey="Shaftman S" first="Stephanie R." last="Shaftman">Stephanie R. Shaftman</name><affiliation wicri:level="1"><inist:fA14 i1="07"><s1>Biostatistics, Bioinformatics, and Epidemiology, Medical University of South Carolina</s1><s2>Charleston, South Carolina</s2><s3>USA</s3><sZ>6 aut.</sZ></inist:fA14><country>États-Unis</country></affiliation></author><author><name sortKey="Tison, Francois" sort="Tison, Francois" uniqKey="Tison F" first="François" last="Tison">François Tison</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Reference Centre for MSA, University Hospital, INSERM U1048 Eq8</s1><s2>Toulouse</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>7 aut.</sZ><sZ>14 aut.</sZ></inist:fA14><country>France</country></affiliation><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Explorations Fonctionnelles, University Hospital</s1><s2>Brest</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>7 aut.</sZ><sZ>14 aut.</sZ></inist:fA14><country>France</country></affiliation><affiliation wicri:level="1"><inist:fA14 i1="08"><s1>Department of Neurology, University Hospital of Bordeaux</s1><s2>Pessac</s2><s3>FRA</s3><sZ>7 aut.</sZ></inist:fA14><country>France</country></affiliation></author><author><name sortKey="Wenning, Gregor K" sort="Wenning, Gregor K" uniqKey="Wenning G" first="Gregor K." last="Wenning">Gregor K. Wenning</name><affiliation wicri:level="1"><inist:fA14 i1="04"><s1>Division of Clinical Neurobiology, Medical University</s1><s2>Innsbruck</s2><s3>AUT</s3><sZ>3 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>Autriche</country></affiliation></author><author><name sortKey="Goetz, Christopher G" sort="Goetz, Christopher G" uniqKey="Goetz C" first="Christopher G." last="Goetz">Christopher G. Goetz</name><affiliation wicri:level="1"><inist:fA14 i1="09"><s1>Department of Neurological Services, Rush University School of Medicine</s1><s2>Chicago, Illinois</s2><s3>USA</s3><sZ>9 aut.</sZ><sZ>13 aut.</sZ></inist:fA14><country>États-Unis</country></affiliation></author><author><name sortKey="Poewe, Werner" sort="Poewe, Werner" uniqKey="Poewe W" first="Werner" last="Poewe">Werner Poewe</name><affiliation wicri:level="1"><inist:fA14 i1="10"><s1>Department of Neurology, Innsbruck Medical University</s1><s2>Innsbruck</s2><s3>AUT</s3><sZ>10 aut.</sZ></inist:fA14><country>Autriche</country></affiliation></author><author><name sortKey="Sampaio, Cristina" sort="Sampaio, Cristina" uniqKey="Sampaio C" first="Cristina" last="Sampaio">Cristina Sampaio</name><affiliation wicri:level="1"><inist:fA14 i1="11"><s1>Laboratory of Clinical Pharmacology and Therapeutics, Lisbon School of Medicine</s1><s2>Lisbon</s2><s3>PRT</s3><sZ>11 aut.</sZ></inist:fA14><country>Portugal</country></affiliation></author><author><name sortKey="Schrag, Anette" sort="Schrag, Anette" uniqKey="Schrag A" first="Anette" last="Schrag">Anette Schrag</name><affiliation wicri:level="1"><inist:fA14 i1="12"><s1>Department of Clinical Neurosciences, Royal Free Hospital, University College London</s1><s2>London</s2><s3>GBR</s3><sZ>12 aut.</sZ></inist:fA14><country>Royaume-Uni</country></affiliation></author><author><name sortKey="Stebbins, Glenn T" sort="Stebbins, Glenn T" uniqKey="Stebbins G" first="Glenn T." last="Stebbins">Glenn T. Stebbins</name><affiliation wicri:level="1"><inist:fA14 i1="09"><s1>Department of Neurological Services, Rush University School of Medicine</s1><s2>Chicago, Illinois</s2><s3>USA</s3><sZ>9 aut.</sZ><sZ>13 aut.</sZ></inist:fA14><country>États-Unis</country></affiliation></author><author><name sortKey="Rascol, Olivier" sort="Rascol, Olivier" uniqKey="Rascol O" first="Olivier" last="Rascol">Olivier Rascol</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Reference Centre for MSA, University Hospital, INSERM U1048 Eq8</s1><s2>Toulouse</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>7 aut.</sZ><sZ>14 aut.</sZ></inist:fA14><country>France</country></affiliation><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Explorations Fonctionnelles, University Hospital</s1><s2>Brest</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>7 aut.</sZ><sZ>14 aut.</sZ></inist:fA14><country>France</country></affiliation><affiliation wicri:level="1"><inist:fA14 i1="13"><s1>Department of Clinical Pharmacology and Clinical Investigation Center, University Hospital and University of Toulouse III</s1><s2>Toulouse</s2><s3>FRA</s3><sZ>14 aut.</sZ></inist:fA14><country>France</country></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>Diseases of the autonomic nervous system</term><term>Force</term><term>Nervous system diseases</term><term>Parkinson disease</term><term>Postural hypotension</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Maladie de Parkinson</term><term>Hypotension artérielle orthostatique</term><term>Pathologie du système nerveux autonome</term><term>Pathologie du système nerveux</term><term>Force</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Orthostatic hypotension is defined as a blood pressure fall of > 20 mm Hg systolic and/or 10 mm Hg diastolic within 3 minutes of an upright position. The Movement Disorders Society commissioned a task force to assess existing clinical rating scales addressing symptoms of orthostatic hypotension in Parkinson's disease. Seven neurologists and a clinimetrician assessed each scale's previous use and critiqued its clinimetric properties. A scale was "recommended" if it had been applied to populations of patients with Parkinson's disease, with data on its use in studies beyond the group that developed the scale, and was found to be clinimetrically valid. A scale was considered "suggested" if it had been applied to Parkinson's disease, but only 1 of the other criteria was applied. A scale was "listed" if it met only 1 criterion. Symptoms of orthostatic hypotension are generally assessed in scales on wider autonomic or nonmotor symptoms. Some scales designed to detect orthostatic hypotension-related symptoms provide information on their severity: the AUTonomic SCale for Outcomes in PArkinson's Disease and the COMPosite Autonomic Symptom Scale met criteria for recommended with some limitations; the Novel Non-Motor Symptoms Scale and the Orthostatic Grading Scale were classified as suggested. The Self-completed Non-Motor Symptoms Questionnaire for Parkinson's Disease was classified as suggested as a tool for screening orthostatic symptoms. However, these and the listed scales need further validation and application before they can be recommended for clinical use in patients with Parkinson's disease.</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>11</s2></fA06><fA08 i1="01" i2="1" l="ENG"><s1>The Movement Disorders Task Force Review of Dysautonomia Rating Scales in Parkinson's Disease with Regard to Symptoms of Orthostatic Hypotension</s1></fA08><fA11 i1="01" i2="1"><s1>PAVY-LE TRAON (Anne)</s1></fA11><fA11 i1="02" i2="1"><s1>AMARENCO (Gerard)</s1></fA11><fA11 i1="03" i2="1"><s1>DUERR (Susanne)</s1></fA11><fA11 i1="04" i2="1"><s1>KAUFMANN (Horacio)</s1></fA11><fA11 i1="05" i2="1"><s1>LAHRMANN (Heinz)</s1></fA11><fA11 i1="06" i2="1"><s1>SHAFTMAN (Stephanie R.)</s1></fA11><fA11 i1="07" i2="1"><s1>TISON (François)</s1></fA11><fA11 i1="08" i2="1"><s1>WENNING (Gregor K.)</s1></fA11><fA11 i1="09" i2="1"><s1>GOETZ (Christopher G.)</s1></fA11><fA11 i1="10" i2="1"><s1>POEWE (Werner)</s1></fA11><fA11 i1="11" i2="1"><s1>SAMPAIO (Cristina)</s1></fA11><fA11 i1="12" i2="1"><s1>SCHRAG (Anette)</s1></fA11><fA11 i1="13" i2="1"><s1>STEBBINS (Glenn T.)</s1></fA11><fA11 i1="14" i2="1"><s1>RASCOL (Olivier)</s1></fA11><fA14 i1="01"><s1>Reference Centre for MSA, University Hospital, INSERM U1048 Eq8</s1><s2>Toulouse</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>7 aut.</sZ><sZ>14 aut.</sZ></fA14><fA14 i1="02"><s1>Explorations Fonctionnelles, University Hospital</s1><s2>Brest</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>7 aut.</sZ><sZ>14 aut.</sZ></fA14><fA14 i1="03"><s1>Service de Rééducation Neurologique et d'Explorations Périnéales, Rothschild Hospital</s1><s2>Paris</s2><s3>FRA</s3><sZ>2 aut.</sZ></fA14><fA14 i1="04"><s1>Division of Clinical Neurobiology, Medical University</s1><s2>Innsbruck</s2><s3>AUT</s3><sZ>3 aut.</sZ><sZ>8 aut.</sZ></fA14><fA14 i1="05"><s1>Department of Neurology, New York University, New York</s1><s2>New York</s2><s3>USA</s3><sZ>4 aut.</sZ></fA14><fA14 i1="06"><s1>Department of Neurology, Kaiser Franz Josef Hospital</s1><s2>Vienna</s2><s3>AUT</s3><sZ>5 aut.</sZ></fA14><fA14 i1="07"><s1>Biostatistics, Bioinformatics, and Epidemiology, Medical University of South Carolina</s1><s2>Charleston, South Carolina</s2><s3>USA</s3><sZ>6 aut.</sZ></fA14><fA14 i1="08"><s1>Department of Neurology, University Hospital of Bordeaux</s1><s2>Pessac</s2><s3>FRA</s3><sZ>7 aut.</sZ></fA14><fA14 i1="09"><s1>Department of Neurological Services, Rush University School of Medicine</s1><s2>Chicago, Illinois</s2><s3>USA</s3><sZ>9 aut.</sZ><sZ>13 aut.</sZ></fA14><fA14 i1="10"><s1>Department of Neurology, Innsbruck Medical University</s1><s2>Innsbruck</s2><s3>AUT</s3><sZ>10 aut.</sZ></fA14><fA14 i1="11"><s1>Laboratory of Clinical Pharmacology and Therapeutics, Lisbon School of Medicine</s1><s2>Lisbon</s2><s3>PRT</s3><sZ>11 aut.</sZ></fA14><fA14 i1="12"><s1>Department of Clinical Neurosciences, Royal Free Hospital, University College London</s1><s2>London</s2><s3>GBR</s3><sZ>12 aut.</sZ></fA14><fA14 i1="13"><s1>Department of Clinical Pharmacology and Clinical Investigation Center, University Hospital and University of Toulouse III</s1><s2>Toulouse</s2><s3>FRA</s3><sZ>14 aut.</sZ></fA14><fA20><s1>1985-1992</s1></fA20><fA21><s1>2011</s1></fA21><fA23 i1="01"><s0>ENG</s0></fA23><fA43 i1="01"><s1>INIST</s1><s2>20953</s2><s5>354000509954560040</s5></fA43><fA44><s0>0000</s0><s1>© 2011 INIST-CNRS. All rights reserved.</s1></fA44><fA45><s0>46 ref.</s0></fA45><fA47 i1="01" i2="1"><s0>11-0444600</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>Orthostatic hypotension is defined as a blood pressure fall of > 20 mm Hg systolic and/or 10 mm Hg diastolic within 3 minutes of an upright position. The Movement Disorders Society commissioned a task force to assess existing clinical rating scales addressing symptoms of orthostatic hypotension in Parkinson's disease. Seven neurologists and a clinimetrician assessed each scale's previous use and critiqued its clinimetric properties. A scale was "recommended" if it had been applied to populations of patients with Parkinson's disease, with data on its use in studies beyond the group that developed the scale, and was found to be clinimetrically valid. A scale was considered "suggested" if it had been applied to Parkinson's disease, but only 1 of the other criteria was applied. A scale was "listed" if it met only 1 criterion. Symptoms of orthostatic hypotension are generally assessed in scales on wider autonomic or nonmotor symptoms. Some scales designed to detect orthostatic hypotension-related symptoms provide information on their severity: the AUTonomic SCale for Outcomes in PArkinson's Disease and the COMPosite Autonomic Symptom Scale met criteria for recommended with some limitations; the Novel Non-Motor Symptoms Scale and the Orthostatic Grading Scale were classified as suggested. The Self-completed Non-Motor Symptoms Questionnaire for Parkinson's Disease was classified as suggested as a tool for screening orthostatic symptoms. However, these and the listed scales need further validation and application before they can be recommended for clinical use in patients with Parkinson's disease.</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>Maladie de Parkinson</s0><s2>NM</s2><s5>01</s5></fC03><fC03 i1="01" i2="X" l="ENG"><s0>Parkinson disease</s0><s2>NM</s2><s5>01</s5></fC03><fC03 i1="01" i2="X" l="SPA"><s0>Parkinson enfermedad</s0><s2>NM</s2><s5>01</s5></fC03><fC03 i1="02" i2="X" l="FRE"><s0>Hypotension artérielle orthostatique</s0><s2>NM</s2><s5>02</s5></fC03><fC03 i1="02" i2="X" l="ENG"><s0>Postural hypotension</s0><s2>NM</s2><s5>02</s5></fC03><fC03 i1="02" i2="X" l="SPA"><s0>Hipotensión arterial ortostática</s0><s2>NM</s2><s5>02</s5></fC03><fC03 i1="03" i2="X" l="FRE"><s0>Pathologie du système nerveux autonome</s0><s5>03</s5></fC03><fC03 i1="03" i2="X" l="ENG"><s0>Diseases of the autonomic nervous system</s0><s5>03</s5></fC03><fC03 i1="03" i2="X" l="SPA"><s0>Sistema nervioso autónomo patología</s0><s5>03</s5></fC03><fC03 i1="04" i2="X" l="FRE"><s0>Pathologie du système nerveux</s0><s5>04</s5></fC03><fC03 i1="04" i2="X" l="ENG"><s0>Nervous system diseases</s0><s5>04</s5></fC03><fC03 i1="04" i2="X" l="SPA"><s0>Sistema nervioso patología</s0><s5>04</s5></fC03><fC03 i1="05" i2="X" l="FRE"><s0>Force</s0><s5>09</s5></fC03><fC03 i1="05" i2="X" l="ENG"><s0>Force</s0><s5>09</s5></fC03><fC03 i1="05" i2="X" l="SPA"><s0>Fuerza</s0><s5>09</s5></fC03><fC07 i1="01" i2="X" l="FRE"><s0>Hypotension artérielle</s0></fC07><fC07 i1="01" i2="X" l="ENG"><s0>Arterial hypotension</s0></fC07><fC07 i1="01" i2="X" l="SPA"><s0>Hipotensión arterial</s0></fC07><fC07 i1="02" i2="X" l="FRE"><s0>Pathologie de l'encéphale</s0><s5>37</s5></fC07><fC07 i1="02" i2="X" l="ENG"><s0>Cerebral disorder</s0><s5>37</s5></fC07><fC07 i1="02" i2="X" l="SPA"><s0>Encéfalo patología</s0><s5>37</s5></fC07><fC07 i1="03" i2="X" l="FRE"><s0>Syndrome extrapyramidal</s0><s5>38</s5></fC07><fC07 i1="03" i2="X" l="ENG"><s0>Extrapyramidal syndrome</s0><s5>38</s5></fC07><fC07 i1="03" i2="X" l="SPA"><s0>Extrapiramidal síndrome</s0><s5>38</s5></fC07><fC07 i1="04" i2="X" l="FRE"><s0>Maladie dégénérative</s0><s5>39</s5></fC07><fC07 i1="04" i2="X" l="ENG"><s0>Degenerative disease</s0><s5>39</s5></fC07><fC07 i1="04" i2="X" l="SPA"><s0>Enfermedad degenerativa</s0><s5>39</s5></fC07><fC07 i1="05" i2="X" l="FRE"><s0>Pathologie du système nerveux central</s0><s5>40</s5></fC07><fC07 i1="05" i2="X" l="ENG"><s0>Central nervous system disease</s0><s5>40</s5></fC07><fC07 i1="05" i2="X" l="SPA"><s0>Sistema nervosio central patología</s0><s5>40</s5></fC07><fC07 i1="06" i2="X" l="FRE"><s0>Pathologie de l'appareil circulatoire</s0><s5>42</s5></fC07><fC07 i1="06" i2="X" l="ENG"><s0>Cardiovascular disease</s0><s5>42</s5></fC07><fC07 i1="06" i2="X" l="SPA"><s0>Aparato circulatorio patología</s0><s5>42</s5></fC07><fN21><s1>305</s1></fN21><fN44 i1="01"><s1>OTO</s1></fN44><fN82><s1>OTO</s1></fN82></pA></standard></inist></record>Pour manipuler ce document sous Unix (Dilib)
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