Progression of Parkinson's disease as evaluated by Hoehn and Yahr stage transition times
Identifieur interne : 000135 ( Main/Corpus ); précédent : 000134; suivant : 000136Progression of Parkinson's disease as evaluated by Hoehn and Yahr stage transition times
Auteurs : Ying Jiao Zhao ; Hwee Lin Wee ; Yiong-Huak Chan ; Soo Hoon Seah ; Wing Lok Au ; Puay Ngoh Lau ; Emmanuel Camara Pica ; Shu Chuen Li ; Nan Luo ; Louis C. S. TanSource :
- Movement Disorders [ 0885-3185 ] ; 2010-04-30.
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Abstract
This study was carried out to evaluate progression in Parkinson's disease (PD) by analyzing time taken to transit from one Hoehn and Yahr (H&Y) stage to the next stage and to investigate the variables that would be associated with H&Y transition times using a large PD database that contained prospectively collected information. Data were obtained from the movement disorder database of the National Neuroscience Institute in Singapore. Kaplan‐Meier (KM) survival analysis was adopted to investigate the time taken to progress through various H&Y stages. Cox regression analysis was used to examine the association between the baseline variables at the entry point of each H&Y stage and the progression to the next stage. A total of 695 patients (mean age: 65.2, male: 57.3%) were studied. Using KM analysis, the median time taken to transit from H&Y stage 1 to 2, 2 to 2.5, 2.5 to 3 were 20, 62, and 25 months, respectively; whereas the median time taken to progress from stage 3 to 4 and 4 to 5 were 24 and 26 months, respectively. Cox regression analysis revealed that older age‐at‐diagnosis, longer PD duration, and higher Unified Parkinson's Disease Rating Scale (UPDRS) motor scores at baseline were associated with a significantly faster progression through various H&Y stages. Gender and ethnicity were not associated with disease progression. In conclusion, H&Y transition time is a useful measure of disease progression in PD and may be utilized in clinical studies evaluating therapeutic interventions and prognostic factors in PD. © 2010 Movement Disorder Society
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DOI: 10.1002/mds.22875
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S." last="Tan">Louis C. S. Tan</name><affiliation><mods:affiliation>Parkinson's Disease and Movement Disorders Center, Department of Neurology, National Neuroscience Institute, Republic of Singapore, USA, National Parkinson Foundation International Centre of Excellence</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Movement Disorders</title><title level="j" type="abbrev">Mov. 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>Hoboken</pubPlace><date type="published" when="2010-04-30">2010-04-30</date><biblScope unit="volume">25</biblScope><biblScope unit="issue">6</biblScope><biblScope unit="page" from="710">710</biblScope><biblScope unit="page" to="716">716</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">E1422341D7A6410CBC1BB6EFAAB4DCE50B10AB3D</idno><idno type="DOI">10.1002/mds.22875</idno><idno type="ArticleID">MDS22875</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>H&Y</term><term>Parkinson's disease</term><term>progression</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">This study was carried out to evaluate progression in Parkinson's disease (PD) by analyzing time taken to transit from one Hoehn and Yahr (H&Y) stage to the next stage and to investigate the variables that would be associated with H&Y transition times using a large PD database that contained prospectively collected information. Data were obtained from the movement disorder database of the National Neuroscience Institute in Singapore. Kaplan‐Meier (KM) survival analysis was adopted to investigate the time taken to progress through various H&Y stages. Cox regression analysis was used to examine the association between the baseline variables at the entry point of each H&Y stage and the progression to the next stage. A total of 695 patients (mean age: 65.2, male: 57.3%) were studied. Using KM analysis, the median time taken to transit from H&Y stage 1 to 2, 2 to 2.5, 2.5 to 3 were 20, 62, and 25 months, respectively; whereas the median time taken to progress from stage 3 to 4 and 4 to 5 were 24 and 26 months, respectively. Cox regression analysis revealed that older age‐at‐diagnosis, longer PD duration, and higher Unified Parkinson's Disease Rating Scale (UPDRS) motor scores at baseline were associated with a significantly faster progression through various H&Y stages. Gender and ethnicity were not associated with disease progression. In conclusion, H&Y transition time is a useful measure of disease progression in PD and may be utilized in clinical studies evaluating therapeutic interventions and prognostic factors in PD. © 2010 Movement Disorder Society</div></front></TEI><istex><corpusName>wiley</corpusName><author><json:item><name>Ying Jiao Zhao BSc</name><affiliations><json:string>Department of Pharmacy, National University of Singapore, Republic of Singapore</json:string></affiliations></json:item><json:item><name>Hwee Lin Wee PhD</name><affiliations><json:string>Department of Pharmacy, National University of Singapore, Republic of Singapore</json:string></affiliations></json:item><json:item><name>Yiong‐Huak Chan PhD</name><affiliations><json:string>Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Republic of Singapore</json:string></affiliations></json:item><json:item><name>Soo Hoon Seah</name><affiliations><json:string>Parkinson's Disease and Movement Disorders Center, Department of Neurology, National Neuroscience Institute, Republic of Singapore, USA, National Parkinson Foundation International Centre of Excellence</json:string></affiliations></json:item><json:item><name>Wing Lok Au FRCP</name><affiliations><json:string>Parkinson's Disease and Movement Disorders Center, Department of Neurology, National Neuroscience Institute, Republic of Singapore, USA, National Parkinson Foundation International Centre of Excellence</json:string></affiliations></json:item><json:item><name>Puay Ngoh Lau BHSc</name><affiliations><json:string>Parkinson's Disease and Movement Disorders Center, Department of Neurology, National Neuroscience Institute, Republic of Singapore, USA, National Parkinson Foundation International Centre of Excellence</json:string></affiliations></json:item><json:item><name>Emmanuel Camara Pica MD</name><affiliations><json:string>Parkinson's Disease and Movement Disorders Center, Department of Neurology, National Neuroscience Institute, Republic of Singapore, USA, National Parkinson Foundation International Centre of Excellence</json:string></affiliations></json:item><json:item><name>Shu Chuen Li PhD</name><affiliations><json:string>Discipline of Pharmacy & Experimental Pharmacology, School of Biomedical Sciences, University of Newcastle, Australia</json:string></affiliations></json:item><json:item><name>Nan Luo PhD</name><affiliations><json:string>Department of Epidemiology and Public Health, National University of Singapore, Republic of Singapore</json:string><json:string>Centre for Health Services Research, National University of Singapore, Republic of Singapore</json:string></affiliations></json:item><json:item><name>Louis C.S. Tan FRCP</name><affiliations><json:string>Parkinson's Disease and Movement Disorders Center, Department of Neurology, National Neuroscience Institute, Republic of Singapore, USA, National Parkinson Foundation International Centre of Excellence</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>progression</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>H&Y</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Parkinson's disease</value></json:item></subject><articleId><json:string>MDS22875</json:string></articleId><language><json:string>eng</json:string></language><abstract>This study was carried out to evaluate progression in Parkinson's disease (PD) by analyzing time taken to transit from one Hoehn and Yahr (H&Y) stage to the next stage and to investigate the variables that would be associated with H&Y transition times using a large PD database that contained prospectively collected information. Data were obtained from the movement disorder database of the National Neuroscience Institute in Singapore. Kaplan‐Meier (KM) survival analysis was adopted to investigate the time taken to progress through various H&Y stages. Cox regression analysis was used to examine the association between the baseline variables at the entry point of each H&Y stage and the progression to the next stage. A total of 695 patients (mean age: 65.2, male: 57.3%) were studied. Using KM analysis, the median time taken to transit from H&Y stage 1 to 2, 2 to 2.5, 2.5 to 3 were 20, 62, and 25 months, respectively; whereas the median time taken to progress from stage 3 to 4 and 4 to 5 were 24 and 26 months, respectively. Cox regression analysis revealed that older age‐at‐diagnosis, longer PD duration, and higher Unified Parkinson's Disease Rating Scale (UPDRS) motor scores at baseline were associated with a significantly faster progression through various H&Y stages. Gender and ethnicity were not associated with disease progression. 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times</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><availability><p>WILEY</p></availability><date>2010</date></publicationStmt><notesStmt><note type="content">*Potential conflict of interest: Nothing to report.</note><note>Singapore Millennium Foundation</note></notesStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">Progression of Parkinson's disease as evaluated by Hoehn and Yahr stage transition times</title><author><persName><forename type="first">Ying Jiao</forename><surname>Zhao</surname></persName><roleName type="degree">BSc</roleName><affiliation>Department of Pharmacy, National University of Singapore, Republic of Singapore</affiliation></author><author><persName><forename type="first">Hwee Lin</forename><surname>Wee</surname></persName><roleName type="degree">PhD</roleName><affiliation>Department of Pharmacy, National University of Singapore, Republic of Singapore</affiliation></author><author><persName><forename type="first">Yiong‐Huak</forename><surname>Chan</surname></persName><roleName type="degree">PhD</roleName><affiliation>Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Republic of Singapore</affiliation></author><author><persName><forename type="first">Soo Hoon</forename><surname>Seah</surname></persName><affiliation>Parkinson's Disease and Movement Disorders Center, Department of Neurology, National Neuroscience Institute, Republic of Singapore, USA, National Parkinson Foundation International Centre of Excellence</affiliation></author><author><persName><forename type="first">Wing Lok</forename><surname>Au</surname></persName><roleName type="degree">FRCP</roleName><affiliation>Parkinson's Disease and Movement Disorders Center, Department of Neurology, National Neuroscience Institute, Republic of Singapore, USA, National Parkinson Foundation International Centre of Excellence</affiliation></author><author><persName><forename type="first">Puay Ngoh</forename><surname>Lau</surname></persName><roleName type="degree">BHSc</roleName><affiliation>Parkinson's Disease and Movement Disorders Center, Department of Neurology, National Neuroscience Institute, Republic of Singapore, USA, National Parkinson Foundation International Centre of Excellence</affiliation></author><author><persName><forename type="first">Emmanuel Camara</forename><surname>Pica</surname></persName><roleName type="degree">MD</roleName><affiliation>Parkinson's Disease and Movement Disorders Center, Department of Neurology, National Neuroscience Institute, Republic of Singapore, USA, National Parkinson Foundation International Centre of Excellence</affiliation></author><author><persName><forename type="first">Shu Chuen</forename><surname>Li</surname></persName><roleName type="degree">PhD</roleName><affiliation>Discipline of Pharmacy & Experimental Pharmacology, School of Biomedical Sciences, University of Newcastle, Australia</affiliation></author><author><persName><forename type="first">Nan</forename><surname>Luo</surname></persName><roleName type="degree">PhD</roleName><affiliation>Department of Epidemiology and Public Health, National University of Singapore, Republic of Singapore</affiliation><affiliation>Centre for Health Services Research, National University of Singapore, Republic of Singapore</affiliation></author><author><persName><forename type="first">Louis C.S.</forename><surname>Tan</surname></persName><roleName type="degree">FRCP</roleName><note type="correspondence"><p>Correspondence: National Neuroscience Institute, 11 Jalan Tan Tock Seng, Singapore 308433</p></note><affiliation>Parkinson's Disease and Movement Disorders Center, Department of Neurology, National Neuroscience Institute, Republic of Singapore, USA, National Parkinson Foundation International Centre of Excellence</affiliation></author></analytic><monogr><title level="j">Movement Disorders</title><title level="j" type="abbrev">Mov. 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Data were obtained from the movement disorder database of the National Neuroscience Institute in Singapore. Kaplan‐Meier (KM) survival analysis was adopted to investigate the time taken to progress through various H&Y stages. Cox regression analysis was used to examine the association between the baseline variables at the entry point of each H&Y stage and the progression to the next stage. A total of 695 patients (mean age: 65.2, male: 57.3%) were studied. Using KM analysis, the median time taken to transit from H&Y stage 1 to 2, 2 to 2.5, 2.5 to 3 were 20, 62, and 25 months, respectively; whereas the median time taken to progress from stage 3 to 4 and 4 to 5 were 24 and 26 months, respectively. Cox regression analysis revealed that older age‐at‐diagnosis, longer PD duration, and higher Unified Parkinson's Disease Rating Scale (UPDRS) motor scores at baseline were associated with a significantly faster progression through various H&Y stages. Gender and ethnicity were not associated with disease progression. In conclusion, H&Y transition time is a useful measure of disease progression in PD and may be utilized in clinical studies evaluating therapeutic interventions and prognostic factors in PD. © 2010 Movement Disorder Society</p></abstract><textClass xml:lang="en"><keywords scheme="keyword"><list><head>Keywords</head><item><term>progression</term></item><item><term>H&Y</term></item><item><term>Parkinson's disease</term></item></list></keywords></textClass><textClass><keywords scheme="Journal Subject"><list><head>article category</head><item><term>Research Article</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2009-07-28">Received</change><change when="2009-10-10">Registration</change><change when="2010-04-30">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/E1422341D7A6410CBC1BB6EFAAB4DCE50B10AB3D/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>Wiley Subscription Services, Inc., A Wiley Company</publisherName><publisherLoc>Hoboken</publisherLoc></publisherInfo><doi registered="yes">10.1002/(ISSN)1531-8257</doi><issn type="print">0885-3185</issn><issn type="electronic">1531-8257</issn><idGroup><id type="product" value="MDS"></id></idGroup><titleGroup><title type="main" xml:lang="en" sort="MOVEMENT DISORDERS">Movement Disorders</title><title type="short">Mov. 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type="figureTotal" number="1"></count><count type="tableTotal" number="3"></count><count type="referenceTotal" number="28"></count><count type="wordTotal" number="5844"></count></countGroup><titleGroup><title type="main" xml:lang="en">Progression of Parkinson's disease as evaluated by Hoehn and Yahr stage transition times<link href="#fn1"></link></title><title type="short" xml:lang="en">Progression of Parkinson's Disease</title></titleGroup><creators><creator xml:id="au1" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Ying Jiao</givenNames><familyName>Zhao</familyName><degrees>BSc</degrees></personName></creator><creator xml:id="au2" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Hwee Lin</givenNames><familyName>Wee</familyName><degrees>PhD</degrees></personName></creator><creator xml:id="au3" creatorRole="author" affiliationRef="#af2"><personName><givenNames>Yiong‐Huak</givenNames><familyName>Chan</familyName><degrees>PhD</degrees></personName></creator><creator xml:id="au4" creatorRole="author" affiliationRef="#af3"><personName><givenNames>Soo Hoon</givenNames><familyName>Seah</familyName></personName></creator><creator xml:id="au5" creatorRole="author" affiliationRef="#af3"><personName><givenNames>Wing Lok</givenNames><familyName>Au</familyName><degrees>FRCP</degrees></personName></creator><creator xml:id="au6" creatorRole="author" affiliationRef="#af3"><personName><givenNames>Puay Ngoh</givenNames><familyName>Lau</familyName><degrees>BHSc</degrees></personName></creator><creator xml:id="au7" creatorRole="author" affiliationRef="#af3"><personName><givenNames>Emmanuel Camara</givenNames><familyName>Pica</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au8" creatorRole="author" affiliationRef="#af4"><personName><givenNames>Shu Chuen</givenNames><familyName>Li</familyName><degrees>PhD</degrees></personName></creator><creator xml:id="au9" creatorRole="author" affiliationRef="#af5 #af6"><personName><givenNames>Nan</givenNames><familyName>Luo</familyName><degrees>PhD</degrees></personName></creator><creator xml:id="au10" creatorRole="author" affiliationRef="#af3" corresponding="yes"><personName><givenNames>Louis C.S.</givenNames><familyName>Tan</familyName><degrees>FRCP</degrees></personName><contactDetails><email>louis_tan@nni.com.sg</email></contactDetails></creator></creators><affiliationGroup><affiliation xml:id="af1" countryCode="SG" type="organization"><unparsedAffiliation>Department of Pharmacy, National University of Singapore, Republic of Singapore</unparsedAffiliation></affiliation><affiliation xml:id="af2" countryCode="SG" type="organization"><unparsedAffiliation>Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Republic of Singapore</unparsedAffiliation></affiliation><affiliation xml:id="af3" countryCode="SG" type="organization"><unparsedAffiliation>Parkinson's Disease and Movement Disorders Center, Department of Neurology, National Neuroscience Institute, Republic of Singapore, USA, National Parkinson Foundation International Centre of Excellence</unparsedAffiliation></affiliation><affiliation xml:id="af4" countryCode="AU" type="organization"><unparsedAffiliation>Discipline of Pharmacy & Experimental Pharmacology, School of Biomedical Sciences, University of Newcastle, Australia</unparsedAffiliation></affiliation><affiliation xml:id="af5" countryCode="SG" type="organization"><unparsedAffiliation>Department of Epidemiology and Public Health, National University of Singapore, Republic of Singapore</unparsedAffiliation></affiliation><affiliation xml:id="af6" countryCode="SG" type="organization"><unparsedAffiliation>Centre for Health Services Research, National University of Singapore, Republic of Singapore</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en" type="author"><keyword xml:id="kwd1">progression</keyword><keyword xml:id="kwd2">H&Y</keyword><keyword xml:id="kwd3">Parkinson's disease</keyword></keywordGroup><fundingInfo><fundingAgency>Singapore Millennium Foundation</fundingAgency></fundingInfo><abstractGroup><abstract type="main" xml:lang="en"><title type="main">Abstract</title><p>This study was carried out to evaluate progression in Parkinson's disease (PD) by analyzing time taken to transit from one Hoehn and Yahr (H&Y) stage to the next stage and to investigate the variables that would be associated with H&Y transition times using a large PD database that contained prospectively collected information. Data were obtained from the movement disorder database of the National Neuroscience Institute in Singapore. Kaplan‐Meier (KM) survival analysis was adopted to investigate the time taken to progress through various H&Y stages. Cox regression analysis was used to examine the association between the baseline variables at the entry point of each H&Y stage and the progression to the next stage. A total of 695 patients (mean age: 65.2, male: 57.3%) were studied. Using KM analysis, the median time taken to transit from H&Y stage 1 to 2, 2 to 2.5, 2.5 to 3 were 20, 62, and 25 months, respectively; whereas the median time taken to progress from stage 3 to 4 and 4 to 5 were 24 and 26 months, respectively. Cox regression analysis revealed that older age‐at‐diagnosis, longer PD duration, and higher Unified Parkinson's Disease Rating Scale (UPDRS) motor scores at baseline were associated with a significantly faster progression through various H&Y stages. Gender and ethnicity were not associated with disease progression. In conclusion, H&Y transition time is a useful measure of disease progression in PD and may be utilized in clinical studies evaluating therapeutic interventions and prognostic factors in PD. © 2010 Movement Disorder Society</p></abstract></abstractGroup></contentMeta><noteGroup><note xml:id="fn1"><p>Potential conflict of interest: Nothing to report.</p></note></noteGroup></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Progression of Parkinson's disease as evaluated by Hoehn and Yahr stage transition times</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Progression of Parkinson's Disease</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Progression of Parkinson's disease as evaluated by Hoehn and Yahr stage transition times</title></titleInfo><name type="personal"><namePart type="given">Ying Jiao</namePart><namePart type="family">Zhao</namePart><namePart type="termsOfAddress">BSc</namePart><affiliation>Department of Pharmacy, National University of Singapore, Republic of Singapore</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Hwee Lin</namePart><namePart type="family">Wee</namePart><namePart type="termsOfAddress">PhD</namePart><affiliation>Department of Pharmacy, National University of Singapore, Republic of Singapore</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Yiong‐Huak</namePart><namePart type="family">Chan</namePart><namePart type="termsOfAddress">PhD</namePart><affiliation>Biostatistics Unit, Yong Loo Lin School of Medicine, National University of Singapore, Republic of Singapore</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Soo Hoon</namePart><namePart type="family">Seah</namePart><affiliation>Parkinson's Disease and Movement Disorders Center, Department of Neurology, National Neuroscience Institute, Republic of Singapore, USA, National Parkinson Foundation International Centre of Excellence</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Wing Lok</namePart><namePart type="family">Au</namePart><namePart type="termsOfAddress">FRCP</namePart><affiliation>Parkinson's Disease and Movement Disorders Center, Department of Neurology, National Neuroscience Institute, Republic of Singapore, USA, National Parkinson Foundation International Centre of Excellence</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Puay Ngoh</namePart><namePart type="family">Lau</namePart><namePart type="termsOfAddress">BHSc</namePart><affiliation>Parkinson's Disease and Movement Disorders Center, Department of Neurology, National Neuroscience Institute, Republic of Singapore, USA, National Parkinson Foundation International Centre of Excellence</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Emmanuel Camara</namePart><namePart type="family">Pica</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Parkinson's Disease and Movement Disorders Center, Department of Neurology, National Neuroscience Institute, Republic of Singapore, USA, National Parkinson Foundation International Centre of Excellence</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Shu Chuen</namePart><namePart type="family">Li</namePart><namePart type="termsOfAddress">PhD</namePart><affiliation>Discipline of Pharmacy & Experimental Pharmacology, School of Biomedical Sciences, University of Newcastle, Australia</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Nan</namePart><namePart type="family">Luo</namePart><namePart type="termsOfAddress">PhD</namePart><affiliation>Department of Epidemiology and Public Health, National University of Singapore, Republic of Singapore</affiliation><affiliation>Centre for Health Services Research, National University of Singapore, Republic of Singapore</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Louis C.S.</namePart><namePart type="family">Tan</namePart><namePart type="termsOfAddress">FRCP</namePart><affiliation>Parkinson's Disease and Movement Disorders Center, Department of Neurology, National Neuroscience Institute, Republic of Singapore, USA, National Parkinson Foundation International Centre of Excellence</affiliation><description>Correspondence: National Neuroscience Institute, 11 Jalan Tan Tock Seng, Singapore 308433</description><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article"></genre><originInfo><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><place><placeTerm type="text">Hoboken</placeTerm></place><dateIssued encoding="w3cdtf">2010-04-30</dateIssued><dateCaptured encoding="w3cdtf">2009-07-28</dateCaptured><dateValid encoding="w3cdtf">2009-10-10</dateValid><copyrightDate encoding="w3cdtf">2010</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="figures">1</extent><extent unit="tables">3</extent><extent unit="references">28</extent><extent unit="words">5844</extent></physicalDescription><abstract lang="en">This study was carried out to evaluate progression in Parkinson's disease (PD) by analyzing time taken to transit from one Hoehn and Yahr (H&Y) stage to the next stage and to investigate the variables that would be associated with H&Y transition times using a large PD database that contained prospectively collected information. Data were obtained from the movement disorder database of the National Neuroscience Institute in Singapore. Kaplan‐Meier (KM) survival analysis was adopted to investigate the time taken to progress through various H&Y stages. Cox regression analysis was used to examine the association between the baseline variables at the entry point of each H&Y stage and the progression to the next stage. A total of 695 patients (mean age: 65.2, male: 57.3%) were studied. Using KM analysis, the median time taken to transit from H&Y stage 1 to 2, 2 to 2.5, 2.5 to 3 were 20, 62, and 25 months, respectively; whereas the median time taken to progress from stage 3 to 4 and 4 to 5 were 24 and 26 months, respectively. Cox regression analysis revealed that older age‐at‐diagnosis, longer PD duration, and higher Unified Parkinson's Disease Rating Scale (UPDRS) motor scores at baseline were associated with a significantly faster progression through various H&Y stages. Gender and ethnicity were not associated with disease progression. In conclusion, H&Y transition time is a useful measure of disease progression in PD and may be utilized in clinical studies evaluating therapeutic interventions and prognostic factors in PD. © 2010 Movement Disorder Society</abstract><note type="content">*Potential conflict of interest: Nothing to report.</note><note type="funding">Singapore Millennium Foundation</note><subject lang="en"><genre>Keywords</genre><topic>progression</topic><topic>H&Y</topic><topic>Parkinson's disease</topic></subject><relatedItem type="host"><titleInfo><title>Movement Disorders</title></titleInfo><titleInfo type="abbreviated"><title>Mov. Disord.</title></titleInfo><genre type="Journal">journal</genre><subject><genre>article category</genre><topic>Research Article</topic></subject><identifier type="ISSN">0885-3185</identifier><identifier type="eISSN">1531-8257</identifier><identifier type="DOI">10.1002/(ISSN)1531-8257</identifier><identifier type="PublisherID">MDS</identifier><part><date>2010</date><detail type="volume"><caption>vol.</caption><number>25</number></detail><detail type="issue"><caption>no.</caption><number>6</number></detail><extent unit="pages"><start>710</start><end>716</end><total>7</total></extent></part></relatedItem><identifier type="istex">E1422341D7A6410CBC1BB6EFAAB4DCE50B10AB3D</identifier><identifier type="DOI">10.1002/mds.22875</identifier><identifier type="ArticleID">MDS22875</identifier><accessCondition type="use and reproduction" contentType="copyright">Copyright © 2010 Movement Disorder Society</accessCondition><recordInfo><recordContentSource>WILEY</recordContentSource><recordOrigin>Wiley Subscription Services, Inc., A Wiley Company</recordOrigin></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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