Rate of clinical progression in Parkinson's disease. A prospective study
Identifieur interne : 000502 ( Main/Corpus ); précédent : 000501; suivant : 000503Rate of clinical progression in Parkinson's disease. A prospective study
Auteurs : Anette Schrag ; Richard Dodel ; Annika Spottke ; Bernhard Bornschein ; Uwe Siebert ; Niall P. QuinnSource :
- Movement Disorders [ 0885-3185 ] ; 2007-05-15.
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Abstract
Few prospective data on the clinical progression of Parkinson's disease (PD) in patient groups outside treatment trials in selected patients are available, and controversy exists on the rate of clinical disease progression with advancing disease. In this study, we investigated the rate of clinical progression of PD in a clinic‐based sample of 145 patients over 1 year and in a community‐based sample of 124 patients over 4 years. Depending on the sample and clinical scale used, mean deterioration of motor and disability scores ranged from 2.4 to 7.4% of the maximum possible score per year, and standard deviations indicated that there was considerable variability of progression rates between individuals. The progression of motor scores decreased with follow‐up over 4 years and significantly decreased in more advanced disease stages. Deterioration of disability scores did not differ between disease stages; this may reflect the increasing rate of disease complications, which contribute to increasing disability in addition to motor impairment alone, in more advanced disease. Thus, motor fluctuations, hallucinations, depression, memory problems, and bladder symptoms were all reported more often at follow‐up in the community‐based sample (all P < 0.01), and dyskinesias, motor fluctuations, falls, and hallucinations were more common and cognitive and depression scores worse in higher disease stages in the clinic‐based sample (all P < 0.001). We conclude that progression of motor scores in PD decreases with advancing disease in PD. However, disability continues to deteriorate with advancing disease and with the development of disease complications that are likely to be related to additional extrastriatal pathology. © 2007 Movement Disorder Society
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DOI: 10.1002/mds.21429
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In this study, we investigated the rate of clinical progression of PD in a clinic‐based sample of 145 patients over 1 year and in a community‐based sample of 124 patients over 4 years. Depending on the sample and clinical scale used, mean deterioration of motor and disability scores ranged from 2.4 to 7.4% of the maximum possible score per year, and standard deviations indicated that there was considerable variability of progression rates between individuals. The progression of motor scores decreased with follow‐up over 4 years and significantly decreased in more advanced disease stages. Deterioration of disability scores did not differ between disease stages; this may reflect the increasing rate of disease complications, which contribute to increasing disability in addition to motor impairment alone, in more advanced disease. Thus, motor fluctuations, hallucinations, depression, memory problems, and bladder symptoms were all reported more often at follow‐up in the community‐based sample (all P < 0.01), and dyskinesias, motor fluctuations, falls, and hallucinations were more common and cognitive and depression scores worse in higher disease stages in the clinic‐based sample (all P < 0.001). We conclude that progression of motor scores in PD decreases with advancing disease in PD. 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Thus, motor fluctuations, hallucinations, depression, memory problems, and bladder symptoms were all reported more often at follow‐up in the community‐based sample (all P > 0.01), and dyskinesias, motor fluctuations, falls, and hallucinations were more common and cognitive and depression scores worse in higher disease stages in the clinic‐based sample (all P > 0.001). We conclude that progression of motor scores in PD decreases with advancing disease in PD. 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In this study, we investigated the rate of clinical progression of PD in a clinic‐based sample of 145 patients over 1 year and in a community‐based sample of 124 patients over 4 years. Depending on the sample and clinical scale used, mean deterioration of motor and disability scores ranged from 2.4 to 7.4% of the maximum possible score per year, and standard deviations indicated that there was considerable variability of progression rates between individuals. The progression of motor scores decreased with follow‐up over 4 years and significantly decreased in more advanced disease stages. Deterioration of disability scores did not differ between disease stages; this may reflect the increasing rate of disease complications, which contribute to increasing disability in addition to motor impairment alone, in more advanced disease. Thus, motor fluctuations, hallucinations, depression, memory problems, and bladder symptoms were all reported more often at follow‐up in the community‐based sample (all P < 0.01), and dyskinesias, motor fluctuations, falls, and hallucinations were more common and cognitive and depression scores worse in higher disease stages in the clinic‐based sample (all P < 0.001). We conclude that progression of motor scores in PD decreases with advancing disease in PD. 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In this study, we investigated the rate of clinical progression of PD in a clinic‐based sample of 145 patients over 1 year and in a community‐based sample of 124 patients over 4 years. Depending on the sample and clinical scale used, mean deterioration of motor and disability scores ranged from 2.4 to 7.4% of the maximum possible score per year, and standard deviations indicated that there was considerable variability of progression rates between individuals. The progression of motor scores decreased with follow‐up over 4 years and significantly decreased in more advanced disease stages. Deterioration of disability scores did not differ between disease stages; this may reflect the increasing rate of disease complications, which contribute to increasing disability in addition to motor impairment alone, in more advanced disease. Thus, motor fluctuations, hallucinations, depression, memory problems, and bladder symptoms were all reported more often at follow‐up in the community‐based sample (all <i>P</i> < 0.01), and dyskinesias, motor fluctuations, falls, and hallucinations were more common and cognitive and depression scores worse in higher disease stages in the clinic‐based sample (all <i>P</i> < 0.001). We conclude that progression of motor scores in PD decreases with advancing disease in PD. However, disability continues to deteriorate with advancing disease and with the development of disease complications that are likely to be related to additional extrastriatal pathology. © 2007 Movement Disorder Society</p></abstract></abstractGroup></contentMeta></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Rate of clinical progression in Parkinson's disease. A prospective study</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Clinical Progression in Parkinson′s Disease</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Rate of clinical progression in Parkinson's disease. A prospective study</title></titleInfo><name type="personal"><namePart type="given">Anette</namePart><namePart type="family">Schrag</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Department of Clinical Neurosciences, Royal Free Hospital, University College London, London, United Kingdom</affiliation><affiliation>Department of Motor Neurosciences and Movement Disorders, Institute of Neurology, University College London, London, United Kingdom</affiliation><description>Correspondence: Department of Clinical Neurosciences, Royal Free Hospital, University College London, London NW3 2PF, United Kingdom</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Richard</namePart><namePart type="family">Dodel</namePart><namePart type="termsOfAddress">MD, MPH</namePart><affiliation>Department of Neurology, Philipps‐University Marburg, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Annika</namePart><namePart type="family">Spottke</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Neurology, Philipps‐University Marburg, Germany</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Bernhard</namePart><namePart type="family">Bornschein</namePart><namePart type="termsOfAddress">MD, MPH</namePart><affiliation>UMIT University for Health Sciences, Medical Informatics and Technology, Hall, Austria</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Uwe</namePart><namePart type="family">Siebert</namePart><namePart type="termsOfAddress">MPH, MSc</namePart><affiliation>UMIT University for Health Sciences, Medical Informatics and Technology, Hall, Austria</affiliation><affiliation>Institute for Technology Assessment and Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Niall P.</namePart><namePart type="family">Quinn</namePart><namePart type="termsOfAddress">MD, MRCP</namePart><affiliation>Department of Motor Neurosciences and Movement Disorders, Institute of Neurology, University College London, London, United Kingdom</affiliation><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">2007-05-15</dateIssued><dateCaptured encoding="w3cdtf">2006-07-17</dateCaptured><dateValid encoding="w3cdtf">2007-01-09</dateValid><copyrightDate encoding="w3cdtf">2007</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="tables">5</extent><extent unit="references">53</extent><extent unit="words">6021</extent></physicalDescription><abstract lang="en">Few prospective data on the clinical progression of Parkinson's disease (PD) in patient groups outside treatment trials in selected patients are available, and controversy exists on the rate of clinical disease progression with advancing disease. In this study, we investigated the rate of clinical progression of PD in a clinic‐based sample of 145 patients over 1 year and in a community‐based sample of 124 patients over 4 years. Depending on the sample and clinical scale used, mean deterioration of motor and disability scores ranged from 2.4 to 7.4% of the maximum possible score per year, and standard deviations indicated that there was considerable variability of progression rates between individuals. The progression of motor scores decreased with follow‐up over 4 years and significantly decreased in more advanced disease stages. Deterioration of disability scores did not differ between disease stages; this may reflect the increasing rate of disease complications, which contribute to increasing disability in addition to motor impairment alone, in more advanced disease. Thus, motor fluctuations, hallucinations, depression, memory problems, and bladder symptoms were all reported more often at follow‐up in the community‐based sample (all P < 0.01), and dyskinesias, motor fluctuations, falls, and hallucinations were more common and cognitive and depression scores worse in higher disease stages in the clinic‐based sample (all P < 0.001). We conclude that progression of motor scores in PD decreases with advancing disease in PD. However, disability continues to deteriorate with advancing disease and with the development of disease complications that are likely to be related to additional extrastriatal pathology. © 2007 Movement Disorder Society</abstract><note type="funding">German Ministery of Education and Research (BMBF) - No. 01GI9901/1; </note><subject lang="en"><genre>Keywords</genre><topic>Parkinson's disease</topic><topic>progression</topic><topic>UPDRS</topic><topic>scales</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>2007</date><detail type="volume"><caption>vol.</caption><number>22</number></detail><detail type="issue"><caption>no.</caption><number>7</number></detail><extent unit="pages"><start>938</start><end>945</end><total>8</total></extent></part></relatedItem><identifier type="istex">F1DF8109D628EB376E740F8D6552CED8CE6662B6</identifier><identifier type="DOI">10.1002/mds.21429</identifier><identifier type="ArticleID">MDS21429</identifier><accessCondition type="use and reproduction" contentType="copyright">Copyright © 2007 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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