Dysautonomia rating scales in Parkinson's disease: Sialorrhea, dysphagia, and constipation—Critique and recommendations by movement disorders task force on rating scales for Parkinson's disease
Identifieur interne : 002400 ( Main/Corpus ); précédent : 002399; suivant : 002401Dysautonomia rating scales in Parkinson's disease: Sialorrhea, dysphagia, and constipation—Critique and recommendations by movement disorders task force on rating scales for Parkinson's disease
Auteurs : Marian L. Evatt ; K. Ray Chaudhuri ; Kelvin L. Chou ; Ester Cubo ; Vanessa Hinson ; Katie Kompoliti ; Chengwu Yang ; Werner Poewe ; Olivier Rascol ; Cristina Sampaio ; Glenn T. Stebbins ; Christopher G. GoetzSource :
- Movement Disorders [ 0885-3185 ] ; 2009-04-15.
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Abstract
Upper and lower gastrointestinal dysautonomia symptoms (GIDS)—sialorrhea, dysphagia, and constipation are common in Parkinson's disease (PD) and often socially as well as physically disabling for patients. Available invasive quantitative measures for assessing these symptoms and their response to therapy are time‐consuming, require specialized equipment, can cause patient discomfort and present patients with risk. The Movement Disorders Society commissioned a task force to assess available clinical rating scales, critique their clinimetric properties, and make recommendations regarding their clinical utility. Six clinical researchers and a biostatistician systematically searched the literature for scales of sialorrhea, dysphagia, and constipation, evaluated the scales' previous use, performance parameters, and quality of validation data (if available). A scale was designated “Recommended” if the scale was used in clinical studies beyond the group that developed it, has been specifically used in PD reports, and clinimetric studies have established that it is a valid, reliable, and sensitive. “Suggested” scales met at least part of the above criteria, but fell short of meeting all. Based on the systematic review, scales for individual symptoms of sialorrhea, dysphagia, and constipation were identified along with three global scales that include these symptoms in the context of assessing dysautonomia or nonmotor symptoms. Three sialorrhea scales met criteria for Suggested: Drooling Severity and Frequency Scale (DSFS), Drooling Rating Scale, and Sialorrhea Clinical Scale for PD (SCS‐PD). Two dysphagia scales, the Swallowing Disturbance Questionnaire (SDQ) and Dysphagia‐Specific Quality of Life (SWAL‐QOL), met criteria for Suggested. Although Rome III constipation module is widely accepted in the gastroenterology community, and the earlier version from the Rome II criteria has been used in a single study of PD patients, neither met criteria for Suggested or Recommended. Among the global scales, the Scales for Outcomes in PD‐Autonomic (SCOPA‐AUT) and Nonmotor Symptoms Questionnaire for PD (NMSQuest) both met criteria for Recommended, and the Nonmotor Symptoms Scale (NMSS) met criteria for Suggested; however, none specifically focuses on the target gastrointestinal symptoms (sialorrhea, dysphagia, and constipation) of this report. A very small number of rating scales have been applied to studies of gastrointestinal‐related dysautonomia in PD. Only two scales met “Recommended” criteria and neither focuses specifically on the symptoms of sialorrhea, dysphagia, and constipation. Further scale testing in PD among the scales that focus on these symptoms is warranted, and no new scales are needed until the available scales are fully tested clinimetrically. © 2009 Movement Disorder Society
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DOI: 10.1002/mds.22260
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Ray Chaudhuri</name><affiliation><mods:affiliation>National Parkinson Foundation Centre of Excellence, Kings College Hospital, Institute of Psychiatry, London, United Kingdom</mods:affiliation></affiliation></author><author><name sortKey="Chou, Kelvin L" sort="Chou, Kelvin L" uniqKey="Chou K" first="Kelvin L." last="Chou">Kelvin L. 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Evatt</name><affiliation><mods:affiliation>Section of Movement Disorders, Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA</mods:affiliation></affiliation></author><author><name sortKey="Chaudhuri, K Ray" sort="Chaudhuri, K Ray" uniqKey="Chaudhuri K" first="K. Ray" last="Chaudhuri">K. Ray Chaudhuri</name><affiliation><mods:affiliation>National Parkinson Foundation Centre of Excellence, Kings College Hospital, Institute of Psychiatry, London, United Kingdom</mods:affiliation></affiliation></author><author><name sortKey="Chou, Kelvin L" sort="Chou, Kelvin L" uniqKey="Chou K" first="Kelvin L." last="Chou">Kelvin L. Chou</name><affiliation><mods:affiliation>Department of Neurology, University of Michigan Medical School, Ann Arbor, Michigan, USA</mods:affiliation></affiliation></author><author><name sortKey="Cubo, Ester" sort="Cubo, Ester" uniqKey="Cubo E" first="Ester" last="Cubo">Ester Cubo</name><affiliation><mods:affiliation>Neurology Department, Hospital General Yagüe, Burgos, Spain</mods:affiliation></affiliation></author><author><name sortKey="Hinson, Vanessa" sort="Hinson, Vanessa" uniqKey="Hinson V" first="Vanessa" last="Hinson">Vanessa Hinson</name><affiliation><mods:affiliation>Department of Neurosciences, Medical University of South Carolina, Charleston, South Carolina, USA</mods:affiliation></affiliation></author><author><name sortKey="Kompoliti, Katie" sort="Kompoliti, Katie" uniqKey="Kompoliti K" first="Katie" last="Kompoliti">Katie Kompoliti</name><affiliation><mods:affiliation>Department of Neurological Services, Rush University School of Medicine, Chicago, Illinois, USA</mods:affiliation></affiliation></author><author><name sortKey="Yang, Chengwu" sort="Yang, Chengwu" uniqKey="Yang C" first="Chengwu" last="Yang">Chengwu Yang</name><affiliation><mods:affiliation>Department of Neurosciences, Medical University of South Carolina, Charleston, South Carolina, USA</mods:affiliation></affiliation></author><author><name sortKey="Poewe, Werner" sort="Poewe, Werner" uniqKey="Poewe W" first="Werner" last="Poewe">Werner Poewe</name><affiliation><mods:affiliation>Department of Biostatistics, Medical University of South Carolina, Charleston, South Carolina, USA</mods:affiliation></affiliation></author><author><name sortKey="Rascol, Olivier" sort="Rascol, Olivier" uniqKey="Rascol O" first="Olivier" last="Rascol">Olivier Rascol</name><affiliation><mods:affiliation>Department of Neurology, University Hospital, Innsbruck, Austria</mods:affiliation></affiliation></author><author><name sortKey="Sampaio, Cristina" sort="Sampaio, Cristina" uniqKey="Sampaio C" first="Cristina" last="Sampaio">Cristina Sampaio</name><affiliation><mods:affiliation>Laboratoire de Pharmacologie Médicale et Clinique, Toulouse, France</mods:affiliation></affiliation><affiliation><mods:affiliation>Laboratory of Clinical Pharmacology and Therapeutics, Lisbon School of Medicine, Lisbon, Portugal</mods:affiliation></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><mods:affiliation>Department of Neurological Services, Rush University School of Medicine, Chicago, Illinois, USA</mods:affiliation></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><mods:affiliation>Department of Neurological Services, Rush University School of Medicine, Chicago, Illinois, USA</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Movement Disorders</title><title level="j" type="sub">Official Journal of the Movement Disorder Society</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="2009-04-15">2009-04-15</date><biblScope unit="volume">24</biblScope><biblScope unit="issue">5</biblScope><biblScope unit="page" from="635">635</biblScope><biblScope unit="page" to="646">646</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">1641B1C36EBF4F2E524F60EBE418D7142A12993D</idno><idno type="DOI">10.1002/mds.22260</idno><idno type="ArticleID">MDS22260</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Parkinson's disease</term><term>constipation</term><term>dysphagia</term><term>gastrointestinal dysautonomia</term><term>rating scales</term><term>sialorrhea</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Upper and lower gastrointestinal dysautonomia symptoms (GIDS)—sialorrhea, dysphagia, and constipation are common in Parkinson's disease (PD) and often socially as well as physically disabling for patients. Available invasive quantitative measures for assessing these symptoms and their response to therapy are time‐consuming, require specialized equipment, can cause patient discomfort and present patients with risk. The Movement Disorders Society commissioned a task force to assess available clinical rating scales, critique their clinimetric properties, and make recommendations regarding their clinical utility. Six clinical researchers and a biostatistician systematically searched the literature for scales of sialorrhea, dysphagia, and constipation, evaluated the scales' previous use, performance parameters, and quality of validation data (if available). A scale was designated “Recommended” if the scale was used in clinical studies beyond the group that developed it, has been specifically used in PD reports, and clinimetric studies have established that it is a valid, reliable, and sensitive. “Suggested” scales met at least part of the above criteria, but fell short of meeting all. Based on the systematic review, scales for individual symptoms of sialorrhea, dysphagia, and constipation were identified along with three global scales that include these symptoms in the context of assessing dysautonomia or nonmotor symptoms. Three sialorrhea scales met criteria for Suggested: Drooling Severity and Frequency Scale (DSFS), Drooling Rating Scale, and Sialorrhea Clinical Scale for PD (SCS‐PD). Two dysphagia scales, the Swallowing Disturbance Questionnaire (SDQ) and Dysphagia‐Specific Quality of Life (SWAL‐QOL), met criteria for Suggested. Although Rome III constipation module is widely accepted in the gastroenterology community, and the earlier version from the Rome II criteria has been used in a single study of PD patients, neither met criteria for Suggested or Recommended. Among the global scales, the Scales for Outcomes in PD‐Autonomic (SCOPA‐AUT) and Nonmotor Symptoms Questionnaire for PD (NMSQuest) both met criteria for Recommended, and the Nonmotor Symptoms Scale (NMSS) met criteria for Suggested; however, none specifically focuses on the target gastrointestinal symptoms (sialorrhea, dysphagia, and constipation) of this report. A very small number of rating scales have been applied to studies of gastrointestinal‐related dysautonomia in PD. Only two scales met “Recommended” criteria and neither focuses specifically on the symptoms of sialorrhea, dysphagia, and constipation. Further scale testing in PD among the scales that focus on these symptoms is warranted, and no new scales are needed until the available scales are fully tested clinimetrically. © 2009 Movement Disorder Society</div></front></TEI><istex><corpusName>wiley</corpusName><author><json:item><name>Marian L. Evatt MD, MS</name><affiliations><json:string>Section of Movement Disorders, Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA</json:string></affiliations></json:item><json:item><name>K. Ray Chaudhuri MD, FRCP</name><affiliations><json:string>National Parkinson Foundation Centre of Excellence, Kings College Hospital, Institute of Psychiatry, London, United Kingdom</json:string></affiliations></json:item><json:item><name>Kelvin L. Chou MD</name><affiliations><json:string>Department of Neurology, University of Michigan Medical School, Ann Arbor, Michigan, USA</json:string></affiliations></json:item><json:item><name>Ester Cubo MD, PhD</name><affiliations><json:string>Neurology Department, Hospital General Yagüe, Burgos, Spain</json:string></affiliations></json:item><json:item><name>Vanessa Hinson MD, PhD</name><affiliations><json:string>Department of Neurosciences, Medical University of South Carolina, Charleston, South Carolina, USA</json:string></affiliations></json:item><json:item><name>Katie Kompoliti MD</name><affiliations><json:string>Department of Neurological Services, Rush University School of Medicine, Chicago, Illinois, USA</json:string></affiliations></json:item><json:item><name>Chengwu Yang MS, PhD</name><affiliations><json:string>Department of Neurosciences, Medical University of South Carolina, Charleston, South Carolina, USA</json:string></affiliations></json:item><json:item><name>Werner Poewe MD</name><affiliations><json:string>Department of Biostatistics, Medical University of South Carolina, Charleston, South Carolina, USA</json:string></affiliations></json:item><json:item><name>Olivier Rascol MD</name><affiliations><json:string>Department of Neurology, University Hospital, Innsbruck, Austria</json:string></affiliations></json:item><json:item><name>Cristina Sampaio MD, PhD</name><affiliations><json:string>Laboratoire de Pharmacologie Médicale et Clinique, Toulouse, France</json:string><json:string>Laboratory of Clinical Pharmacology and Therapeutics, Lisbon School of Medicine, Lisbon, Portugal</json:string></affiliations></json:item><json:item><name>Glenn T. Stebbins PhD</name><affiliations><json:string>Department of Neurological Services, Rush University School of Medicine, Chicago, Illinois, USA</json:string></affiliations></json:item><json:item><name>Christopher G. Goetz MD</name><affiliations><json:string>Department of Neurological Services, Rush University School of Medicine, Chicago, Illinois, USA</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>sialorrhea</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>constipation</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>dysphagia</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>rating scales</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Parkinson's disease</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>gastrointestinal dysautonomia</value></json:item></subject><articleId><json:string>MDS22260</json:string></articleId><language><json:string>eng</json:string></language><abstract>Upper and lower gastrointestinal dysautonomia symptoms (GIDS)—sialorrhea, dysphagia, and constipation are common in Parkinson's disease (PD) and often socially as well as physically disabling for patients. Available invasive quantitative measures for assessing these symptoms and their response to therapy are time‐consuming, require specialized equipment, can cause patient discomfort and present patients with risk. The Movement Disorders Society commissioned a task force to assess available clinical rating scales, critique their clinimetric properties, and make recommendations regarding their clinical utility. Six clinical researchers and a biostatistician systematically searched the literature for scales of sialorrhea, dysphagia, and constipation, evaluated the scales' previous use, performance parameters, and quality of validation data (if available). A scale was designated “Recommended” if the scale was used in clinical studies beyond the group that developed it, has been specifically used in PD reports, and clinimetric studies have established that it is a valid, reliable, and sensitive. “Suggested” scales met at least part of the above criteria, but fell short of meeting all. Based on the systematic review, scales for individual symptoms of sialorrhea, dysphagia, and constipation were identified along with three global scales that include these symptoms in the context of assessing dysautonomia or nonmotor symptoms. Three sialorrhea scales met criteria for Suggested: Drooling Severity and Frequency Scale (DSFS), Drooling Rating Scale, and Sialorrhea Clinical Scale for PD (SCS‐PD). Two dysphagia scales, the Swallowing Disturbance Questionnaire (SDQ) and Dysphagia‐Specific Quality of Life (SWAL‐QOL), met criteria for Suggested. Although Rome III constipation module is widely accepted in the gastroenterology community, and the earlier version from the Rome II criteria has been used in a single study of PD patients, neither met criteria for Suggested or Recommended. Among the global scales, the Scales for Outcomes in PD‐Autonomic (SCOPA‐AUT) and Nonmotor Symptoms Questionnaire for PD (NMSQuest) both met criteria for Recommended, and the Nonmotor Symptoms Scale (NMSS) met criteria for Suggested; however, none specifically focuses on the target gastrointestinal symptoms (sialorrhea, dysphagia, and constipation) of this report. A very small number of rating scales have been applied to studies of gastrointestinal‐related dysautonomia in PD. Only two scales met “Recommended” criteria and neither focuses specifically on the symptoms of sialorrhea, dysphagia, and constipation. Further scale testing in PD among the scales that focus on these symptoms is warranted, and no new scales are needed until the available scales are fully tested clinimetrically. © 2009 Movement Disorder Society</abstract><qualityIndicators><score>8</score><pdfVersion>1.3</pdfVersion><pdfPageSize>612 x 810 pts</pdfPageSize><refBibsNative>true</refBibsNative><keywordCount>6</keywordCount><abstractCharCount>2826</abstractCharCount><pdfWordCount>6701</pdfWordCount><pdfCharCount>47026</pdfCharCount><pdfPageCount>12</pdfPageCount><abstractWordCount>395</abstractWordCount></qualityIndicators><title>Dysautonomia rating scales in Parkinson's disease: Sialorrhea, dysphagia, and constipation—Critique and recommendations by movement disorders task force on rating scales for Parkinson's disease</title><genre><json:string>review-article</json:string></genre><host><volume>24</volume><publisherId><json:string>MDS</json:string></publisherId><pages><total>12</total><last>646</last><first>635</first></pages><issn><json:string>0885-3185</json:string></issn><issue>5</issue><subject><json:item><value>Review</value></json:item></subject><genre><json:string>Journal</json:string></genre><language><json:string>unknown</json:string></language><eissn><json:string>1531-8257</json:string></eissn><title>Movement Disorders</title><doi><json:string>10.1002/(ISSN)1531-8257</json:string></doi></host><publicationDate>2009</publicationDate><copyrightDate>2009</copyrightDate><doi><json:string>10.1002/mds.22260</json:string></doi><id>1641B1C36EBF4F2E524F60EBE418D7142A12993D</id><fulltext><json:item><original>true</original><mimetype>application/pdf</mimetype><extension>pdf</extension><uri>https://api.istex.fr/document/1641B1C36EBF4F2E524F60EBE418D7142A12993D/fulltext/pdf</uri></json:item><json:item><original>false</original><mimetype>application/zip</mimetype><extension>zip</extension><uri>https://api.istex.fr/document/1641B1C36EBF4F2E524F60EBE418D7142A12993D/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/1641B1C36EBF4F2E524F60EBE418D7142A12993D/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main" xml:lang="en">Dysautonomia rating scales in Parkinson's disease: Sialorrhea, dysphagia, and constipation—Critique and recommendations by movement disorders task force on rating scales for Parkinson's disease</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><availability><p>WILEY</p></availability><date>2009</date></publicationStmt><notesStmt><note type="content">*Potential conflict of interest: MLE has received honoraium for consultant services and/or speaking engagements from UCB Pharma, Solstice, Allergan. She serves on a clinical trial steering committee for Solstice and has received research support from Merz, Ipsen, Boeringer‐Ingelhiem, Santhera and Schwarz (UCB). KRC has received honorarium for sponsored symposiums in international and national meetings from Boehringer‐Ingelheim, UCB Pharma, Solvay, Britannia and GSK Pharmaceuticals. He also serves in the advisory board for the above companies in addition to Lundbeck. KLC has received honoraria or research support in the past 3 years from Teva, GSK, Boehringer‐Ingelheim, Novartis, and Solstice Neurosciences.</note><note>NIH</note><note>National Institute of Neurological Disorders and Stroke - No. U01NS043127; No. U01NS043128; No. U10NS44415; No. 44555;</note><note>NIA RCMAR - No. 3P30 AG021677‐02S1;</note></notesStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">Dysautonomia rating scales in Parkinson's disease: Sialorrhea, dysphagia, and constipation—Critique and recommendations by movement disorders task force on rating scales for Parkinson's disease</title><author><persName><forename type="first">Marian L.</forename><surname>Evatt</surname></persName><roleName type="degree">MD, MS</roleName><note type="correspondence"><p>Correspondence: 1841 Clifton Rd. NE, Atlanta, GA 30329</p></note><affiliation>Section of Movement Disorders, Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA</affiliation></author><author><persName><forename type="first">K. Ray</forename><surname>Chaudhuri</surname></persName><roleName type="degree">MD, FRCP</roleName><affiliation>National Parkinson Foundation Centre of Excellence, Kings College Hospital, Institute of Psychiatry, London, United Kingdom</affiliation></author><author><persName><forename type="first">Kelvin L.</forename><surname>Chou</surname></persName><roleName type="degree">MD</roleName><affiliation>Department of Neurology, University of Michigan Medical School, Ann Arbor, Michigan, USA</affiliation></author><author><persName><forename type="first">Ester</forename><surname>Cubo</surname></persName><roleName type="degree">MD, PhD</roleName><affiliation>Neurology Department, Hospital General Yagüe, Burgos, Spain</affiliation></author><author><persName><forename type="first">Vanessa</forename><surname>Hinson</surname></persName><roleName type="degree">MD, PhD</roleName><affiliation>Department of Neurosciences, Medical University of South Carolina, Charleston, South Carolina, USA</affiliation></author><author><persName><forename type="first">Katie</forename><surname>Kompoliti</surname></persName><roleName type="degree">MD</roleName><affiliation>Department of Neurological Services, Rush University School of Medicine, Chicago, Illinois, USA</affiliation></author><author><persName><forename type="first">Chengwu</forename><surname>Yang</surname></persName><roleName type="degree">MS, PhD</roleName><affiliation>Department of Neurosciences, Medical University of South Carolina, Charleston, South Carolina, USA</affiliation></author><author><persName><forename type="first">Werner</forename><surname>Poewe</surname></persName><roleName type="degree">MD</roleName><affiliation>Department of Biostatistics, Medical University of South Carolina, Charleston, South Carolina, USA</affiliation></author><author><persName><forename type="first">Olivier</forename><surname>Rascol</surname></persName><roleName type="degree">MD</roleName><affiliation>Department of Neurology, University Hospital, Innsbruck, Austria</affiliation></author><author><persName><forename type="first">Cristina</forename><surname>Sampaio</surname></persName><roleName type="degree">MD, PhD</roleName><affiliation>Laboratoire de Pharmacologie Médicale et Clinique, Toulouse, France</affiliation><affiliation>Laboratory of Clinical Pharmacology and Therapeutics, Lisbon School of Medicine, Lisbon, Portugal</affiliation></author><author><persName><forename type="first">Glenn T.</forename><surname>Stebbins</surname></persName><roleName type="degree">PhD</roleName><affiliation>Department of Neurological Services, Rush University School of Medicine, Chicago, Illinois, USA</affiliation></author><author><persName><forename type="first">Christopher G.</forename><surname>Goetz</surname></persName><roleName type="degree">MD</roleName><affiliation>Department of Neurological Services, Rush University School of Medicine, Chicago, Illinois, USA</affiliation></author></analytic><monogr><title level="j">Movement Disorders</title><title level="j" type="sub">Official Journal of the Movement Disorder Society</title><title level="j" type="abbrev">Mov. 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Available invasive quantitative measures for assessing these symptoms and their response to therapy are time‐consuming, require specialized equipment, can cause patient discomfort and present patients with risk. The Movement Disorders Society commissioned a task force to assess available clinical rating scales, critique their clinimetric properties, and make recommendations regarding their clinical utility. Six clinical researchers and a biostatistician systematically searched the literature for scales of sialorrhea, dysphagia, and constipation, evaluated the scales' previous use, performance parameters, and quality of validation data (if available). A scale was designated “Recommended” if the scale was used in clinical studies beyond the group that developed it, has been specifically used in PD reports, and clinimetric studies have established that it is a valid, reliable, and sensitive. “Suggested” scales met at least part of the above criteria, but fell short of meeting all. Based on the systematic review, scales for individual symptoms of sialorrhea, dysphagia, and constipation were identified along with three global scales that include these symptoms in the context of assessing dysautonomia or nonmotor symptoms. Three sialorrhea scales met criteria for Suggested: Drooling Severity and Frequency Scale (DSFS), Drooling Rating Scale, and Sialorrhea Clinical Scale for PD (SCS‐PD). Two dysphagia scales, the Swallowing Disturbance Questionnaire (SDQ) and Dysphagia‐Specific Quality of Life (SWAL‐QOL), met criteria for Suggested. Although Rome III constipation module is widely accepted in the gastroenterology community, and the earlier version from the Rome II criteria has been used in a single study of PD patients, neither met criteria for Suggested or Recommended. Among the global scales, the Scales for Outcomes in PD‐Autonomic (SCOPA‐AUT) and Nonmotor Symptoms Questionnaire for PD (NMSQuest) both met criteria for Recommended, and the Nonmotor Symptoms Scale (NMSS) met criteria for Suggested; however, none specifically focuses on the target gastrointestinal symptoms (sialorrhea, dysphagia, and constipation) of this report. A very small number of rating scales have been applied to studies of gastrointestinal‐related dysautonomia in PD. Only two scales met “Recommended” criteria and neither focuses specifically on the symptoms of sialorrhea, dysphagia, and constipation. Further scale testing in PD among the scales that focus on these symptoms is warranted, and no new scales are needed until the available scales are fully tested clinimetrically. © 2009 Movement Disorder Society</p></abstract><textClass xml:lang="en"><keywords scheme="keyword"><list><head>Keywords</head><item><term>sialorrhea</term></item><item><term>constipation</term></item><item><term>dysphagia</term></item><item><term>rating scales</term></item><item><term>Parkinson's disease</term></item><item><term>gastrointestinal dysautonomia</term></item></list></keywords></textClass><textClass><keywords scheme="Journal Subject"><list><head>article category</head><item><term>Review</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2008-01-14">Received</change><change when="2008-07-08">Registration</change><change when="2009-04-15">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/1641B1C36EBF4F2E524F60EBE418D7142A12993D/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="subtitle">Official Journal of the Movement Disorder Society</title><title type="short">Mov. 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NE, Atlanta, GA 30329</correspondenceTo><linkGroup><link type="toTypesetVersion" href="file:MDS.MDS22260.pdf"></link></linkGroup></publicationMeta><contentMeta><countGroup><count type="figureTotal" number="0"></count><count type="tableTotal" number="2"></count><count type="referenceTotal" number="70"></count><count type="wordTotal" number="8405"></count></countGroup><titleGroup><title type="main" xml:lang="en">Dysautonomia rating scales in Parkinson's disease: Sialorrhea, dysphagia, and constipation—Critique and recommendations by movement disorders task force on rating scales for Parkinson's disease<link href="#fn14"></link></title><title type="short" xml:lang="en">GI Dysautonomia Rating Scales in PD</title></titleGroup><creators><creator xml:id="au1" creatorRole="author" affiliationRef="#af1" corresponding="yes"><personName><givenNames>Marian L.</givenNames><familyName>Evatt</familyName><degrees>MD, MS</degrees></personName><contactDetails><email>marian.evatt@emoryhealthcare.org</email></contactDetails></creator><creator xml:id="au2" creatorRole="author" affiliationRef="#af2"><personName><givenNames>K. Ray</givenNames><familyName>Chaudhuri</familyName><degrees>MD, FRCP</degrees></personName></creator><creator xml:id="au3" creatorRole="author" affiliationRef="#af3"><personName><givenNames>Kelvin L.</givenNames><familyName>Chou</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au4" creatorRole="author" affiliationRef="#af4"><personName><givenNames>Ester</givenNames><familyName>Cubo</familyName><degrees>MD, PhD</degrees></personName></creator><creator xml:id="au5" creatorRole="author" affiliationRef="#af5"><personName><givenNames>Vanessa</givenNames><familyName>Hinson</familyName><degrees>MD, PhD</degrees></personName></creator><creator xml:id="au6" creatorRole="author" affiliationRef="#af6"><personName><givenNames>Katie</givenNames><familyName>Kompoliti</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au7" creatorRole="author" affiliationRef="#af5"><personName><givenNames>Chengwu</givenNames><familyName>Yang</familyName><degrees>MS, PhD</degrees></personName></creator><creator xml:id="au8" creatorRole="author" affiliationRef="#af7"><personName><givenNames>Werner</givenNames><familyName>Poewe</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au9" creatorRole="author" affiliationRef="#af8"><personName><givenNames>Olivier</givenNames><familyName>Rascol</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au10" creatorRole="author" affiliationRef="#af9 #af10"><personName><givenNames>Cristina</givenNames><familyName>Sampaio</familyName><degrees>MD, PhD</degrees></personName></creator><creator xml:id="au11" creatorRole="author" affiliationRef="#af6"><personName><givenNames>Glenn T.</givenNames><familyName>Stebbins</familyName><degrees>PhD</degrees></personName></creator><creator xml:id="au12" creatorRole="author" affiliationRef="#af6"><personName><givenNames>Christopher G.</givenNames><familyName>Goetz</familyName><degrees>MD</degrees></personName></creator></creators><affiliationGroup><affiliation xml:id="af1" countryCode="US" type="organization"><unparsedAffiliation>Section of Movement Disorders, Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA</unparsedAffiliation></affiliation><affiliation xml:id="af2" countryCode="GB" type="organization"><unparsedAffiliation>National Parkinson Foundation Centre of Excellence, Kings College Hospital, Institute of Psychiatry, London, United Kingdom</unparsedAffiliation></affiliation><affiliation xml:id="af3" countryCode="US" type="organization"><unparsedAffiliation>Department of Neurology, University of Michigan Medical School, Ann Arbor, Michigan, USA</unparsedAffiliation></affiliation><affiliation xml:id="af4" countryCode="ES" type="organization"><unparsedAffiliation>Neurology Department, Hospital General Yagüe, Burgos, Spain</unparsedAffiliation></affiliation><affiliation xml:id="af5" countryCode="US" type="organization"><unparsedAffiliation>Department of Neurosciences, Medical University of South Carolina, Charleston, South Carolina, USA</unparsedAffiliation></affiliation><affiliation xml:id="af6" countryCode="US" type="organization"><unparsedAffiliation>Department of Neurological Services, Rush University School of Medicine, Chicago, Illinois, USA</unparsedAffiliation></affiliation><affiliation xml:id="af7" countryCode="US" type="organization"><unparsedAffiliation>Department of Biostatistics, Medical University of South Carolina, Charleston, South Carolina, USA</unparsedAffiliation></affiliation><affiliation xml:id="af8" countryCode="AT" type="organization"><unparsedAffiliation>Department of Neurology, University Hospital, Innsbruck, Austria</unparsedAffiliation></affiliation><affiliation xml:id="af9" countryCode="FR" type="organization"><unparsedAffiliation>Laboratoire de Pharmacologie Médicale et Clinique, Toulouse, France</unparsedAffiliation></affiliation><affiliation xml:id="af10" countryCode="PT" type="organization"><unparsedAffiliation>Laboratory of Clinical Pharmacology and Therapeutics, Lisbon School of Medicine, Lisbon, Portugal</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en" type="author"><keyword xml:id="kwd1">sialorrhea</keyword><keyword xml:id="kwd2">constipation</keyword><keyword xml:id="kwd3">dysphagia</keyword><keyword xml:id="kwd4">rating scales</keyword><keyword xml:id="kwd5">Parkinson's disease</keyword><keyword xml:id="kwd6">gastrointestinal dysautonomia</keyword></keywordGroup><fundingInfo><fundingAgency>NIH</fundingAgency></fundingInfo><fundingInfo><fundingAgency>National Institute of Neurological Disorders and Stroke</fundingAgency><fundingNumber>U01NS043127</fundingNumber><fundingNumber>U01NS043128</fundingNumber><fundingNumber>U10NS44415</fundingNumber><fundingNumber>44555</fundingNumber></fundingInfo><fundingInfo><fundingAgency>NIA RCMAR</fundingAgency><fundingNumber>3P30 AG021677‐02S1</fundingNumber></fundingInfo><supportingInformation><p> Additional Supporting Information may be found in the online version of this article. </p><supportingInfoItem><mediaResource alt="supporting information" href="urn-x:wiley:08853185:media:mds22260:MDS22260suppmatA"></mediaResource><caption>Evaluation Flow Diagram</caption></supportingInfoItem><supportingInfoItem><mediaResource alt="supporting information" href="urn-x:wiley:08853185:media:mds22260:MDS22260suppmatB"></mediaResource><caption>Detailed Methods for Evaluation of Clinimetric properties</caption></supportingInfoItem><supportingInfoItem><mediaResource alt="supporting information" href="urn-x:wiley:08853185:media:mds22260:MDS22260suppmatC"></mediaResource><caption>Scales not critiqued/reason excluded</caption></supportingInfoItem><supportingInfoItem><mediaResource alt="supporting information" href="urn-x:wiley:08853185:media:mds22260:MDS22260suppmatD"></mediaResource><caption>Drooling Severity and Frequency Scale (DSFS)</caption></supportingInfoItem><supportingInfoItem><mediaResource alt="supporting information" href="urn-x:wiley:08853185:media:mds22260:MDS22260suppmatE"></mediaResource><caption>Drooling Rating Scale</caption></supportingInfoItem><supportingInfoItem><mediaResource alt="supporting information" href="urn-x:wiley:08853185:media:mds22260:MDS22260suppmatF"></mediaResource><caption>Sialorrhea Clinical Scale for PD (SCS‐PD)</caption></supportingInfoItem><supportingInfoItem><mediaResource alt="supporting information" href="urn-x:wiley:08853185:media:mds22260:MDS22260suppmatG"></mediaResource><caption>Swallowing Disturbance Questionnaire (SDQ)</caption></supportingInfoItem><supportingInfoItem><mediaResource alt="supporting information" href="urn-x:wiley:08853185:media:mds22260:MDS22260suppmatH"></mediaResource><caption>Scale for Dysphagia‐Related Outcomes Quality of Life (SWAL‐QOL)</caption></supportingInfoItem><supportingInfoItem><mediaResource alt="supporting information" href="urn-x:wiley:08853185:media:mds22260:survey"></mediaResource><caption>The SWAL‐QOL Survey</caption></supportingInfoItem></supportingInformation><abstractGroup><abstract type="main" xml:lang="en"><title type="main">Abstract</title><p>Upper and lower gastrointestinal dysautonomia symptoms (GIDS)—sialorrhea, dysphagia, and constipation are common in Parkinson's disease (PD) and often socially as well as physically disabling for patients. Available invasive quantitative measures for assessing these symptoms and their response to therapy are time‐consuming, require specialized equipment, can cause patient discomfort and present patients with risk. The Movement Disorders Society commissioned a task force to assess available clinical rating scales, critique their clinimetric properties, and make recommendations regarding their clinical utility. Six clinical researchers and a biostatistician systematically searched the literature for scales of sialorrhea, dysphagia, and constipation, evaluated the scales' previous use, performance parameters, and quality of validation data (if available). A scale was designated “Recommended” if the scale was used in clinical studies beyond the group that developed it, has been specifically used in PD reports, and clinimetric studies have established that it is a valid, reliable, and sensitive. “Suggested” scales met at least part of the above criteria, but fell short of meeting all. Based on the systematic review, scales for individual symptoms of sialorrhea, dysphagia, and constipation were identified along with three global scales that include these symptoms in the context of assessing dysautonomia or nonmotor symptoms. Three sialorrhea scales met criteria for Suggested: Drooling Severity and Frequency Scale (DSFS), Drooling Rating Scale, and Sialorrhea Clinical Scale for PD (SCS‐PD). Two dysphagia scales, the Swallowing Disturbance Questionnaire (SDQ) and Dysphagia‐Specific Quality of Life (SWAL‐QOL), met criteria for Suggested. Although Rome III constipation module is widely accepted in the gastroenterology community, and the earlier version from the Rome II criteria has been used in a single study of PD patients, neither met criteria for Suggested or Recommended. Among the global scales, the Scales for Outcomes in PD‐Autonomic (SCOPA‐AUT) and Nonmotor Symptoms Questionnaire for PD (NMSQuest) both met criteria for Recommended, and the Nonmotor Symptoms Scale (NMSS) met criteria for Suggested; however, none specifically focuses on the target gastrointestinal symptoms (sialorrhea, dysphagia, and constipation) of this report. A very small number of rating scales have been applied to studies of gastrointestinal‐related dysautonomia in PD. Only two scales met “Recommended” criteria and neither focuses specifically on the symptoms of sialorrhea, dysphagia, and constipation. Further scale testing in PD among the scales that focus on these symptoms is warranted, and no new scales are needed until the available scales are fully tested clinimetrically. © 2009 Movement Disorder Society</p></abstract></abstractGroup></contentMeta><noteGroup><note xml:id="fn14"><p>Potential conflict of interest: MLE has received honoraium for consultant services and/or speaking engagements from UCB Pharma, Solstice, Allergan. She serves on a clinical trial steering committee for Solstice and has received research support from Merz, Ipsen, Boeringer‐Ingelhiem, Santhera and Schwarz (UCB). KRC has received honorarium for sponsored symposiums in international and national meetings from Boehringer‐Ingelheim, UCB Pharma, Solvay, Britannia and GSK Pharmaceuticals. He also serves in the advisory board for the above companies in addition to Lundbeck. KLC has received honoraria or research support in the past 3 years from Teva, GSK, Boehringer‐Ingelheim, Novartis, and Solstice Neurosciences.</p></note></noteGroup></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Dysautonomia rating scales in Parkinson's disease: Sialorrhea, dysphagia, and constipation—Critique and recommendations by movement disorders task force on rating scales for Parkinson's disease</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>GI Dysautonomia Rating Scales in PD</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Dysautonomia rating scales in Parkinson's disease: Sialorrhea, dysphagia, and constipation—Critique and recommendations by movement disorders task force on rating scales for Parkinson's disease</title></titleInfo><name type="personal"><namePart type="given">Marian L.</namePart><namePart type="family">Evatt</namePart><namePart type="termsOfAddress">MD, MS</namePart><affiliation>Section of Movement Disorders, Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA</affiliation><description>Correspondence: 1841 Clifton Rd. NE, Atlanta, GA 30329</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">K. Ray</namePart><namePart type="family">Chaudhuri</namePart><namePart type="termsOfAddress">MD, FRCP</namePart><affiliation>National Parkinson Foundation Centre of Excellence, Kings College Hospital, Institute of Psychiatry, London, United Kingdom</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Kelvin L.</namePart><namePart type="family">Chou</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Neurology, University of Michigan Medical School, Ann Arbor, Michigan, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Ester</namePart><namePart type="family">Cubo</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Neurology Department, Hospital General Yagüe, Burgos, Spain</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Vanessa</namePart><namePart type="family">Hinson</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Department of Neurosciences, Medical University of South Carolina, Charleston, South Carolina, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Katie</namePart><namePart type="family">Kompoliti</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Neurological Services, Rush University School of Medicine, Chicago, Illinois, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Chengwu</namePart><namePart type="family">Yang</namePart><namePart type="termsOfAddress">MS, PhD</namePart><affiliation>Department of Neurosciences, Medical University of South Carolina, Charleston, South Carolina, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Werner</namePart><namePart type="family">Poewe</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Biostatistics, Medical University of South Carolina, Charleston, South Carolina, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Olivier</namePart><namePart type="family">Rascol</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Neurology, University Hospital, Innsbruck, Austria</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Cristina</namePart><namePart type="family">Sampaio</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Laboratoire de Pharmacologie Médicale et Clinique, Toulouse, France</affiliation><affiliation>Laboratory of Clinical Pharmacology and Therapeutics, Lisbon School of Medicine, Lisbon, Portugal</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Glenn T.</namePart><namePart type="family">Stebbins</namePart><namePart type="termsOfAddress">PhD</namePart><affiliation>Department of Neurological Services, Rush University School of Medicine, Chicago, Illinois, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Christopher G.</namePart><namePart type="family">Goetz</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Neurological Services, Rush University School of Medicine, Chicago, Illinois, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="review-article" displayLabel="reviewArticle"></genre><originInfo><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><place><placeTerm type="text">Hoboken</placeTerm></place><dateIssued encoding="w3cdtf">2009-04-15</dateIssued><dateCaptured encoding="w3cdtf">2008-01-14</dateCaptured><dateValid encoding="w3cdtf">2008-07-08</dateValid><copyrightDate encoding="w3cdtf">2009</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">2</extent><extent unit="references">70</extent><extent unit="words">8405</extent></physicalDescription><abstract lang="en">Upper and lower gastrointestinal dysautonomia symptoms (GIDS)—sialorrhea, dysphagia, and constipation are common in Parkinson's disease (PD) and often socially as well as physically disabling for patients. Available invasive quantitative measures for assessing these symptoms and their response to therapy are time‐consuming, require specialized equipment, can cause patient discomfort and present patients with risk. The Movement Disorders Society commissioned a task force to assess available clinical rating scales, critique their clinimetric properties, and make recommendations regarding their clinical utility. Six clinical researchers and a biostatistician systematically searched the literature for scales of sialorrhea, dysphagia, and constipation, evaluated the scales' previous use, performance parameters, and quality of validation data (if available). A scale was designated “Recommended” if the scale was used in clinical studies beyond the group that developed it, has been specifically used in PD reports, and clinimetric studies have established that it is a valid, reliable, and sensitive. “Suggested” scales met at least part of the above criteria, but fell short of meeting all. Based on the systematic review, scales for individual symptoms of sialorrhea, dysphagia, and constipation were identified along with three global scales that include these symptoms in the context of assessing dysautonomia or nonmotor symptoms. Three sialorrhea scales met criteria for Suggested: Drooling Severity and Frequency Scale (DSFS), Drooling Rating Scale, and Sialorrhea Clinical Scale for PD (SCS‐PD). Two dysphagia scales, the Swallowing Disturbance Questionnaire (SDQ) and Dysphagia‐Specific Quality of Life (SWAL‐QOL), met criteria for Suggested. Although Rome III constipation module is widely accepted in the gastroenterology community, and the earlier version from the Rome II criteria has been used in a single study of PD patients, neither met criteria for Suggested or Recommended. Among the global scales, the Scales for Outcomes in PD‐Autonomic (SCOPA‐AUT) and Nonmotor Symptoms Questionnaire for PD (NMSQuest) both met criteria for Recommended, and the Nonmotor Symptoms Scale (NMSS) met criteria for Suggested; however, none specifically focuses on the target gastrointestinal symptoms (sialorrhea, dysphagia, and constipation) of this report. A very small number of rating scales have been applied to studies of gastrointestinal‐related dysautonomia in PD. Only two scales met “Recommended” criteria and neither focuses specifically on the symptoms of sialorrhea, dysphagia, and constipation. Further scale testing in PD among the scales that focus on these symptoms is warranted, and no new scales are needed until the available scales are fully tested clinimetrically. © 2009 Movement Disorder Society</abstract><note type="content">*Potential conflict of interest: MLE has received honoraium for consultant services and/or speaking engagements from UCB Pharma, Solstice, Allergan. She serves on a clinical trial steering committee for Solstice and has received research support from Merz, Ipsen, Boeringer‐Ingelhiem, Santhera and Schwarz (UCB). KRC has received honorarium for sponsored symposiums in international and national meetings from Boehringer‐Ingelheim, UCB Pharma, Solvay, Britannia and GSK Pharmaceuticals. He also serves in the advisory board for the above companies in addition to Lundbeck. KLC has received honoraria or research support in the past 3 years from Teva, GSK, Boehringer‐Ingelheim, Novartis, and Solstice Neurosciences.</note><note type="funding">NIH</note><note type="funding">National Institute of Neurological Disorders and Stroke - No. U01NS043127; No. U01NS043128; No. U10NS44415; No. 44555; </note><note type="funding">NIA RCMAR - No. 3P30 AG021677‐02S1; </note><subject lang="en"><genre>Keywords</genre><topic>sialorrhea</topic><topic>constipation</topic><topic>dysphagia</topic><topic>rating scales</topic><topic>Parkinson's disease</topic><topic>gastrointestinal dysautonomia</topic></subject><relatedItem type="host"><titleInfo><title>Movement Disorders</title><subTitle>Official Journal of the Movement Disorder Society</subTitle></titleInfo><titleInfo type="abbreviated"><title>Mov. Disord.</title></titleInfo><genre type="Journal">journal</genre><note type="content"> Additional Supporting Information may be found in the online version of this article.Supporting Info Item: Evaluation Flow Diagram - Detailed Methods for Evaluation of Clinimetric properties - Scales not critiqued/reason excluded - Drooling Severity and Frequency Scale (DSFS) - Drooling Rating Scale - Sialorrhea Clinical Scale for PD (SCS‐PD) - Swallowing Disturbance Questionnaire (SDQ) - Scale for Dysphagia‐Related Outcomes Quality of Life (SWAL‐QOL) - The SWAL‐QOL Survey - </note><subject><genre>article category</genre><topic>Review</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>2009</date><detail type="volume"><caption>vol.</caption><number>24</number></detail><detail type="issue"><caption>no.</caption><number>5</number></detail><extent unit="pages"><start>635</start><end>646</end><total>12</total></extent></part></relatedItem><identifier type="istex">1641B1C36EBF4F2E524F60EBE418D7142A12993D</identifier><identifier type="DOI">10.1002/mds.22260</identifier><identifier type="ArticleID">MDS22260</identifier><accessCondition type="use and reproduction" contentType="copyright">Copyright © 2009 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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