Comparison of patient rated treatment response with measured improvement in Parkinson's disease
Identifieur interne : 002615 ( Main/Corpus ); précédent : 002614; suivant : 002616Comparison of patient rated treatment response with measured improvement in Parkinson's disease
Auteurs : Matthew B. Davidson ; David J M. Mcghee ; Carl E. CounsellSource :
- Journal of Neurology, Neurosurgery & Psychiatry [ 0022-3050 ] ; 2012-10.
Abstract
Background A marked response to dopamine replacement therapy is important in supporting a diagnosis of idiopathic Parkinson's disease (PD). The aim of the study was to compare PD patients' subjective rating of improvement with measured improvement on a number of scales. Methods People with clinically defined PD were identified from a prospective long term follow-up study of incident parkinsonian patients. Changes in the Unified Parkinson's Disease Rating Scale (UPDRS) (activities of daily living and motor subsections), timed tests and Parkinson's Disease Questionnaire, full version, between assessments immediately before starting adequate dopamine replacement and the two subsequent follow-up assessments (mean 6 and 12 months after baseline) were calculated. These were compared with the patients' own subjective ratings of improvement (nil, slight, moderate, good, excellent). Results 133 patients were included (mean age 71 years, 56% men). Thirty-eight patients were treated with a dopamine agonist and 95 with l-dopa (median l-dopa equivalent dose 300 mg). Most patients showed improvements in their measured scores but there was no statistically significant association between these scores and the patient subjective response, except for the motor UPDRS at the first follow-up. A third of those who showed no improvement in their motor UPDRS at the first follow-up rated their improvement as moderate or better, while 29% of those whose motor UPDRS improved by over 50% said they had no or slight improvement. Conclusion PD patients' subjective ratings of their degree of improvement often do not accurately reflect the degree of objective change in parkinsonian impairment or disability. Clinicians should record a simple measure of motor impairment before and after treatment to assess treatment response more accurately.
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DOI: 10.1136/jnnp-2012-302741
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<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title>Comparison of patient rated treatment response with measured improvement in Parkinson's disease</title><author><name sortKey="Davidson, Matthew B" sort="Davidson, Matthew B" uniqKey="Davidson M" first="Matthew B" last="Davidson">Matthew B. Davidson</name><affiliation><mods:affiliation>Division of Applied Health Sciences, University of Aberdeen, Aberdeen, UK</mods:affiliation></affiliation></author><author><name sortKey="Mcghee, David J M" sort="Mcghee, David J M" uniqKey="Mcghee D" first="David J M" last="Mcghee">David J M. Mcghee</name><affiliation><mods:affiliation>Division of Applied Health Sciences, University of Aberdeen, Aberdeen, UK</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: david.mcghee@abdn.ac.uk</mods:affiliation></affiliation></author><author><name sortKey="Counsell, Carl E" sort="Counsell, Carl E" uniqKey="Counsell C" first="Carl E" last="Counsell">Carl E. Counsell</name><affiliation><mods:affiliation>Division of Applied Health Sciences, University of Aberdeen, Aberdeen, UK</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:E82475E6E919B991299177066D8B2B37339088B5</idno><date when="2012" year="2012">2012</date><idno type="doi">10.1136/jnnp-2012-302741</idno><idno type="url">https://api.istex.fr/document/E82475E6E919B991299177066D8B2B37339088B5/fulltext/pdf</idno><idno type="wicri:Area/Main/Corpus">002615</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a">Comparison of patient rated treatment response with measured improvement in Parkinson's disease</title><author><name sortKey="Davidson, Matthew B" sort="Davidson, Matthew B" uniqKey="Davidson M" first="Matthew B" last="Davidson">Matthew B. Davidson</name><affiliation><mods:affiliation>Division of Applied Health Sciences, University of Aberdeen, Aberdeen, UK</mods:affiliation></affiliation></author><author><name sortKey="Mcghee, David J M" sort="Mcghee, David J M" uniqKey="Mcghee D" first="David J M" last="Mcghee">David J M. Mcghee</name><affiliation><mods:affiliation>Division of Applied Health Sciences, University of Aberdeen, Aberdeen, UK</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: david.mcghee@abdn.ac.uk</mods:affiliation></affiliation></author><author><name sortKey="Counsell, Carl E" sort="Counsell, Carl E" uniqKey="Counsell C" first="Carl E" last="Counsell">Carl E. Counsell</name><affiliation><mods:affiliation>Division of Applied Health Sciences, University of Aberdeen, Aberdeen, UK</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Journal of Neurology, Neurosurgery & Psychiatry</title><title level="j" type="abbrev">J Neurol Neurosurg Psychiatry</title><idno type="ISSN">0022-3050</idno><idno type="eISSN">1468-330X</idno><imprint><publisher>BMJ Publishing Group Ltd</publisher><date type="published" when="2012-10">2012-10</date><biblScope unit="volume">83</biblScope><biblScope unit="issue">10</biblScope><biblScope unit="page" from="1001">1001</biblScope></imprint><idno type="ISSN">0022-3050</idno></series><idno type="istex">E82475E6E919B991299177066D8B2B37339088B5</idno><idno type="DOI">10.1136/jnnp-2012-302741</idno><idno type="href">jnnp-83-1001.pdf</idno><idno type="ArticleID">jnnp-2012-302741</idno><idno type="PMID">22626942</idno><idno type="local">jnnp;83/10/1001</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0022-3050</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract">Background A marked response to dopamine replacement therapy is important in supporting a diagnosis of idiopathic Parkinson's disease (PD). The aim of the study was to compare PD patients' subjective rating of improvement with measured improvement on a number of scales. Methods People with clinically defined PD were identified from a prospective long term follow-up study of incident parkinsonian patients. Changes in the Unified Parkinson's Disease Rating Scale (UPDRS) (activities of daily living and motor subsections), timed tests and Parkinson's Disease Questionnaire, full version, between assessments immediately before starting adequate dopamine replacement and the two subsequent follow-up assessments (mean 6 and 12 months after baseline) were calculated. These were compared with the patients' own subjective ratings of improvement (nil, slight, moderate, good, excellent). Results 133 patients were included (mean age 71 years, 56% men). Thirty-eight patients were treated with a dopamine agonist and 95 with l-dopa (median l-dopa equivalent dose 300 mg). Most patients showed improvements in their measured scores but there was no statistically significant association between these scores and the patient subjective response, except for the motor UPDRS at the first follow-up. A third of those who showed no improvement in their motor UPDRS at the first follow-up rated their improvement as moderate or better, while 29% of those whose motor UPDRS improved by over 50% said they had no or slight improvement. Conclusion PD patients' subjective ratings of their degree of improvement often do not accurately reflect the degree of objective change in parkinsonian impairment or disability. Clinicians should record a simple measure of motor impairment before and after treatment to assess treatment response more accurately.</div></front></TEI><istex><corpusName>bmj</corpusName><author><json:item><name>Matthew B Davidson</name><affiliations><json:string>Division of Applied Health Sciences, University of Aberdeen, Aberdeen, UK</json:string></affiliations></json:item><json:item><name>David J M McGhee</name><affiliations><json:string>Division of Applied Health Sciences, University of Aberdeen, Aberdeen, UK</json:string><json:string>E-mail: david.mcghee@abdn.ac.uk</json:string></affiliations></json:item><json:item><name>Carl E Counsell</name><affiliations><json:string>Division of Applied Health Sciences, University of Aberdeen, Aberdeen, UK</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>Movement disorders</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>JNNP Patients' choice</value></json:item></subject><language><json:string>eng</json:string></language><abstract>Background A marked response to dopamine replacement therapy is important in supporting a diagnosis of idiopathic Parkinson's disease (PD). The aim of the study was to compare PD patients' subjective rating of improvement with measured improvement on a number of scales. Methods People with clinically defined PD were identified from a prospective long term follow-up study of incident parkinsonian patients. Changes in the Unified Parkinson's Disease Rating Scale (UPDRS) (activities of daily living and motor subsections), timed tests and Parkinson's Disease Questionnaire, full version, between assessments immediately before starting adequate dopamine replacement and the two subsequent follow-up assessments (mean 6 and 12 months after baseline) were calculated. These were compared with the patients' own subjective ratings of improvement (nil, slight, moderate, good, excellent). Results 133 patients were included (mean age 71 years, 56% men). Thirty-eight patients were treated with a dopamine agonist and 95 with l-dopa (median l-dopa equivalent dose 300 mg). Most patients showed improvements in their measured scores but there was no statistically significant association between these scores and the patient subjective response, except for the motor UPDRS at the first follow-up. A third of those who showed no improvement in their motor UPDRS at the first follow-up rated their improvement as moderate or better, while 29% of those whose motor UPDRS improved by over 50% said they had no or slight improvement. Conclusion PD patients' subjective ratings of their degree of improvement often do not accurately reflect the degree of objective change in parkinsonian impairment or disability. Clinicians should record a simple measure of motor impairment before and after treatment to assess treatment response more accurately.</abstract><qualityIndicators><score>7.495</score><pdfVersion>1.4</pdfVersion><pdfPageSize>595.276 x 793.701 pts</pdfPageSize><refBibsNative>true</refBibsNative><keywordCount>2</keywordCount><abstractCharCount>1838</abstractCharCount><pdfWordCount>3995</pdfWordCount><pdfCharCount>26251</pdfCharCount><pdfPageCount>5</pdfPageCount><abstractWordCount>266</abstractWordCount></qualityIndicators><title>Comparison of patient rated treatment response with measured improvement in Parkinson's disease</title><pmid><json:string>22626942</json:string></pmid><genre><json:string>research-article</json:string></genre><host><volume>83</volume><pages><first>1001</first></pages><issn><json:string>0022-3050</json:string></issn><issue>10</issue><genre></genre><language><json:string>unknown</json:string></language><eissn><json:string>1468-330X</json:string></eissn><title>Journal of Neurology, Neurosurgery & Psychiatry</title></host><publicationDate>2012</publicationDate><copyrightDate>2012</copyrightDate><doi><json:string>10.1136/jnnp-2012-302741</json:string></doi><id>E82475E6E919B991299177066D8B2B37339088B5</id><fulltext><json:item><original>true</original><mimetype>application/pdf</mimetype><extension>pdf</extension><uri>https://api.istex.fr/document/E82475E6E919B991299177066D8B2B37339088B5/fulltext/pdf</uri></json:item><json:item><original>false</original><mimetype>application/zip</mimetype><extension>zip</extension><uri>https://api.istex.fr/document/E82475E6E919B991299177066D8B2B37339088B5/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/E82475E6E919B991299177066D8B2B37339088B5/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a">Comparison of patient rated treatment response with measured improvement in Parkinson's disease</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>BMJ Publishing Group Ltd</publisher><availability><p>BMJ</p></availability><date>2012-05-24</date></publicationStmt><notesStmt><note>MBD and DJMM are joint first authors and contributed equally to the manuscript.</note></notesStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a">Comparison of patient rated treatment response with measured improvement in Parkinson's disease</title><author><persName><forename type="first">Matthew B</forename><surname>Davidson</surname></persName><affiliation>Division of Applied Health Sciences, University of Aberdeen, Aberdeen, UK</affiliation></author><author corresp="yes"><persName><forename type="first">David J M</forename><surname>McGhee</surname></persName><email>david.mcghee@abdn.ac.uk</email><affiliation>Division of Applied Health Sciences, University of Aberdeen, Aberdeen, UK</affiliation></author><author><persName><forename type="first">Carl E</forename><surname>Counsell</surname></persName><affiliation>Division of Applied Health Sciences, University of Aberdeen, Aberdeen, UK</affiliation></author></analytic><monogr><title level="j">Journal of Neurology, Neurosurgery & Psychiatry</title><title level="j" type="abbrev">J Neurol Neurosurg Psychiatry</title><idno type="pISSN">0022-3050</idno><idno type="eISSN">1468-330X</idno><imprint><publisher>BMJ Publishing Group Ltd</publisher><date type="published" when="2012-10"></date><biblScope unit="volume">83</biblScope><biblScope unit="issue">10</biblScope><biblScope unit="page" from="1001">1001</biblScope></imprint></monogr><idno type="istex">E82475E6E919B991299177066D8B2B37339088B5</idno><idno type="DOI">10.1136/jnnp-2012-302741</idno><idno type="href">jnnp-83-1001.pdf</idno><idno type="ArticleID">jnnp-2012-302741</idno><idno type="PMID">22626942</idno><idno type="local">jnnp;83/10/1001</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2012-05-24</date></creation><langUsage><language ident="en">en</language></langUsage><abstract><p>Background A marked response to dopamine replacement therapy is important in supporting a diagnosis of idiopathic Parkinson's disease (PD). The aim of the study was to compare PD patients' subjective rating of improvement with measured improvement on a number of scales. Methods People with clinically defined PD were identified from a prospective long term follow-up study of incident parkinsonian patients. Changes in the Unified Parkinson's Disease Rating Scale (UPDRS) (activities of daily living and motor subsections), timed tests and Parkinson's Disease Questionnaire, full version, between assessments immediately before starting adequate dopamine replacement and the two subsequent follow-up assessments (mean 6 and 12 months after baseline) were calculated. These were compared with the patients' own subjective ratings of improvement (nil, slight, moderate, good, excellent). Results 133 patients were included (mean age 71 years, 56% men). Thirty-eight patients were treated with a dopamine agonist and 95 with l-dopa (median l-dopa equivalent dose 300 mg). Most patients showed improvements in their measured scores but there was no statistically significant association between these scores and the patient subjective response, except for the motor UPDRS at the first follow-up. A third of those who showed no improvement in their motor UPDRS at the first follow-up rated their improvement as moderate or better, while 29% of those whose motor UPDRS improved by over 50% said they had no or slight improvement. Conclusion PD patients' subjective ratings of their degree of improvement often do not accurately reflect the degree of objective change in parkinsonian impairment or disability. Clinicians should record a simple measure of motor impairment before and after treatment to assess treatment response more accurately.</p></abstract><textClass><keywords scheme="keyword"><list><head>hwp-journal-coll</head><item><term>JNNP Patients' choice</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2012-05-24">Created</change><change when="2012-10">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/E82475E6E919B991299177066D8B2B37339088B5/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="corpus bmj" wicri:toSee="no header"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="no"</istex:xmlDeclaration><istex:docType PUBLIC="-//NLM//DTD Journal Archiving and Interchange DTD v2.3 20070202//EN" URI="archivearticle.dtd" name="istex:docType"></istex:docType><istex:document><article article-type="research-article"><front><journal-meta><journal-id journal-id-type="hwp">jnnp</journal-id><journal-id journal-id-type="nlm-ta">J Neurol Neurosurg Psychiatry</journal-id><journal-id journal-id-type="publisher-id">jnnp</journal-id><journal-title>Journal of Neurology, Neurosurgery & Psychiatry</journal-title><abbrev-journal-title abbrev-type="publisher">J Neurol Neurosurg Psychiatry</abbrev-journal-title><abbrev-journal-title>J Neurol Neurosurg Psychiatry</abbrev-journal-title><issn pub-type="ppub">0022-3050</issn><issn pub-type="epub">1468-330X</issn><publisher><publisher-name>BMJ Publishing Group Ltd</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">jnnp-2012-302741</article-id><article-id pub-id-type="doi">10.1136/jnnp-2012-302741</article-id><article-id pub-id-type="other">jnnp;83/10/1001</article-id><article-id pub-id-type="other">jnnp;jnnp-2012-302741</article-id><article-id pub-id-type="pmid">22626942</article-id><article-id pub-id-type="other">1001</article-id><article-id pub-id-type="other">jnnp-2012-302741</article-id><article-categories><subj-group subj-group-type="heading"><subject>Movement disorders</subject></subj-group><subj-group subj-group-type="hwp-journal-coll"><subject>JNNP Patients' choice</subject></subj-group><series-title>Research paper</series-title></article-categories><title-group><article-title>Comparison of patient rated treatment response with measured improvement in Parkinson's disease</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Davidson</surname><given-names>Matthew B</given-names></name></contrib><contrib contrib-type="author" corresp="yes"><name><surname>McGhee</surname><given-names>David J M</given-names></name></contrib><contrib contrib-type="author"><name><surname>Counsell</surname><given-names>Carl E</given-names></name></contrib></contrib-group><aff>Division of Applied Health Sciences, University of Aberdeen, Aberdeen, UK</aff><author-notes><corresp><label>Correspondence to</label> Dr D J M McGhee, Division of Applied Health Sciences, University of Aberdeen, Polwarth Building, Foresterhill, Aberdeen AB25 2ZD, UK; <email>david.mcghee@abdn.ac.uk</email></corresp><fn fn-type="other"><p>MBD and DJMM are joint first authors and contributed equally to the manuscript.</p></fn></author-notes><pub-date pub-type="epub-original"><day>24</day><month>5</month><year>2012</year></pub-date><pub-date pub-type="ppub"><month>10</month><year>2012</year></pub-date><pub-date pub-type="epub"><day>24</day><month>5</month><year>2012</year></pub-date><volume>83</volume><volume-id pub-id-type="other">83</volume-id><volume-id pub-id-type="other">83</volume-id><issue>10</issue><issue-id pub-id-type="other">jnnp;83/10</issue-id><issue-id pub-id-type="other">10</issue-id><issue-id pub-id-type="other">83/10</issue-id><fpage>1001</fpage><history><date date-type="received"><day>13</day><month>3</month><year>2012</year></date><date date-type="rev-recd"><day>19</day><month>4</month><year>2012</year></date><date date-type="accepted"><day>24</day><month>4</month><year>2012</year></date></history><permissions><copyright-statement>© 2012, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.</copyright-statement><copyright-year>2012</copyright-year></permissions><self-uri content-type="pdf" xlink:role="full-text" xlink:href="jnnp-83-1001.pdf"></self-uri><abstract><sec><title>Background</title><p>A marked response to dopamine replacement therapy is important in supporting a diagnosis of idiopathic Parkinson's disease (PD). The aim of the study was to compare PD patients' subjective rating of improvement with measured improvement on a number of scales.</p></sec><sec><title>Methods</title><p>People with clinically defined PD were identified from a prospective long term follow-up study of incident parkinsonian patients. Changes in the Unified Parkinson's Disease Rating Scale (UPDRS) (activities of daily living and motor subsections), timed tests and Parkinson's Disease Questionnaire, full version, between assessments immediately before starting adequate dopamine replacement and the two subsequent follow-up assessments (mean 6 and 12 months after baseline) were calculated. These were compared with the patients' own subjective ratings of improvement (nil, slight, moderate, good, excellent).</p></sec><sec><title>Results</title><p>133 patients were included (mean age 71 years, 56% men). Thirty-eight patients were treated with a dopamine agonist and 95 with <sc>l</sc>-dopa (median <sc>l</sc>-dopa equivalent dose 300 mg). Most patients showed improvements in their measured scores but there was no statistically significant association between these scores and the patient subjective response, except for the motor UPDRS at the first follow-up. A third of those who showed no improvement in their motor UPDRS at the first follow-up rated their improvement as moderate or better, while 29% of those whose motor UPDRS improved by over 50% said they had no or slight improvement.</p></sec><sec><title>Conclusion</title><p>PD patients' subjective ratings of their degree of improvement often do not accurately reflect the degree of objective change in parkinsonian impairment or disability. Clinicians should record a simple measure of motor impairment before and after treatment to assess treatment response more accurately.</p></sec></abstract></article-meta></front></article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo><partName>Research paper</partName><title>Comparison of patient rated treatment response with measured improvement in Parkinson's disease</title></titleInfo><titleInfo type="alternative" contentType="CDATA"><partName>Research paper</partName><title>Comparison of patient rated treatment response with measured improvement in Parkinson's disease</title></titleInfo><name type="personal"><namePart type="given">Matthew B</namePart><namePart type="family">Davidson</namePart><affiliation>Division of Applied Health Sciences, University of Aberdeen, Aberdeen, UK</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal" displayLabel="corresp"><namePart type="given">David J M</namePart><namePart type="family">McGhee</namePart><affiliation>Division of Applied Health Sciences, University of Aberdeen, Aberdeen, UK</affiliation><affiliation>E-mail: david.mcghee@abdn.ac.uk</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Carl E</namePart><namePart type="family">Counsell</namePart><affiliation>Division of Applied Health Sciences, University of Aberdeen, Aberdeen, UK</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="research-article"></genre><subject><genre>hwp-journal-coll</genre><topic>JNNP Patients' choice</topic></subject><originInfo><publisher>BMJ Publishing Group Ltd</publisher><dateIssued encoding="w3cdtf">2012-10</dateIssued><dateCreated encoding="w3cdtf">2012-05-24</dateCreated><copyrightDate encoding="w3cdtf">2012</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType></physicalDescription><abstract>Background A marked response to dopamine replacement therapy is important in supporting a diagnosis of idiopathic Parkinson's disease (PD). The aim of the study was to compare PD patients' subjective rating of improvement with measured improvement on a number of scales. Methods People with clinically defined PD were identified from a prospective long term follow-up study of incident parkinsonian patients. Changes in the Unified Parkinson's Disease Rating Scale (UPDRS) (activities of daily living and motor subsections), timed tests and Parkinson's Disease Questionnaire, full version, between assessments immediately before starting adequate dopamine replacement and the two subsequent follow-up assessments (mean 6 and 12 months after baseline) were calculated. These were compared with the patients' own subjective ratings of improvement (nil, slight, moderate, good, excellent). Results 133 patients were included (mean age 71 years, 56% men). Thirty-eight patients were treated with a dopamine agonist and 95 with l-dopa (median l-dopa equivalent dose 300 mg). Most patients showed improvements in their measured scores but there was no statistically significant association between these scores and the patient subjective response, except for the motor UPDRS at the first follow-up. A third of those who showed no improvement in their motor UPDRS at the first follow-up rated their improvement as moderate or better, while 29% of those whose motor UPDRS improved by over 50% said they had no or slight improvement. Conclusion PD patients' subjective ratings of their degree of improvement often do not accurately reflect the degree of objective change in parkinsonian impairment or disability. Clinicians should record a simple measure of motor impairment before and after treatment to assess treatment response more accurately.</abstract><note type="footnotes">MBD and DJMM are joint first authors and contributed equally to the manuscript.</note><relatedItem type="host"><titleInfo><title>Journal of Neurology, Neurosurgery & Psychiatry</title></titleInfo><titleInfo type="abbreviated"><title>J Neurol Neurosurg Psychiatry</title></titleInfo><genre type="Journal">journal</genre><identifier type="ISSN">0022-3050</identifier><identifier type="eISSN">1468-330X</identifier><identifier type="PublisherID">jnnp</identifier><identifier type="PublisherID-hwp">jnnp</identifier><identifier type="PublisherID-nlm-ta">J Neurol Neurosurg Psychiatry</identifier><part><date>2012</date><detail type="volume"><caption>vol.</caption><number>83</number></detail><detail type="issue"><caption>no.</caption><number>10</number></detail><extent unit="pages"><start>1001</start></extent></part></relatedItem><identifier type="istex">E82475E6E919B991299177066D8B2B37339088B5</identifier><identifier type="DOI">10.1136/jnnp-2012-302741</identifier><identifier type="href">jnnp-83-1001.pdf</identifier><identifier type="ArticleID">jnnp-2012-302741</identifier><identifier type="PMID">22626942</identifier><identifier type="local">jnnp;83/10/1001</identifier><accessCondition type="use and reproduction" contentType="copyright">© 2012, Published by the BMJ Publishing Group Limited. 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