|Unified Parkinson's disease rating scale|
|Purpose||used to follow the longitudinal course of Parkinson's disease|
The unified Parkinson's disease rating scale (UPDRS) is used to follow the longitudinal course of Parkinson's disease. The UPD rating scale is the most commonly used scale in the clinical study of Parkinson's disease.
The UPDRS is made up of these sections:
These are evaluated by interview and clinical observation. Some sections require multiple grades assigned to each extremity.
Clinicians and researchers alike use the UPDRS and the motor section in particular to follow the progression of a person's Parkinson's disease. Scientific researchers use it to measure benefits from a given therapy in a more unified and accepted rating system. Neurologists also use it in clinical practice to follow the progression of their patients' symptoms in a more objective manner.
Following the UPDRS scores over time provides insight into the patient's disease progression. For instance Michael J. Fox's symptoms started with a slight tremor, so his motor score would have been less than 10. For most patients, the "mentation, behavior and mood" scores increase later in the disease, but a subset exists for whom those symptoms develop early on.
Other rating scales for Parkinson's disease are the Hoehn and Yahr scale and Schwab and England activities of daily living scale, although both of these measures are currently included within the UPDRS in modified format.
In 2007, the Movement Disorder Society (MDS) published a revision of the UPDRS, known as the MDS-UPDRS.The revision became desirable after an MDS-sponsored Task Force on Rating Scales for Parkinson's Disease highlighted the limitations of the original UPDRS. Two major limitations include the lack of consistent anchor among subscales and the low emphasis on the nonmotor features of PD. The modified UPDRS retains the four-scale structure with a reorganization of the various subscales. The scales are now titled; (1) nonmotor experiences of daily living (13 items), (2) motor experiences of daily living (13 items), (3) motor examination (18 items), and (4) motor complications (six items). Each subscale now has 0-4 ratings, where 0 = normal, 1 = slight, 2 = mild, 3 = moderate, and 4 = severe.
Chorea-acanthocytosis, is a rare hereditary disease caused by a mutation in a gene that directs structural proteins in red blood cells. It belongs to a group of four diseases characterized under the name neuroacanthocytosis. When a patient's blood is viewed under a microscope, some of the red blood cells appear thorny. These thorny cells are called acanthocytes.
Corticobasal degeneration (CBD) is a rare neurodegenerative disease involving the cerebral cortex and the basal ganglia. CBD symptoms typically begin in people from 50 to 70 years of age, and the average disease duration is six years. It is characterized by marked disorders in movement and cognition, and is classified as one of the Parkinson plus syndromes. Diagnosis is difficult, as symptoms are often similar to those of other disorders, such as Parkinson's disease, progressive supranuclear palsy, and dementia with Lewy bodies, and a definitive diagnosis of CBD can only be made upon neuropathologic examination.
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The Hoehn and Yahr scale is a commonly used system for describing how the symptoms of Parkinson's disease progress. It was originally published in 1967 in the journal Neurology by Margaret Hoehn and Melvin Yahr and included stages 1 through 5. Since then, a modified Hoehn and Yahr scale was proposed with the addition of stages 1.5 and 2.5 to help describe the intermediate course of the disease.
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Dihydroergocryptine is a dopamine agonist of the ergoline chemical class that is used as an antiparkinson agent. Dihydroergocryptine has been shown to be particularly effective as monotherapy in the early stages of Parkinson's disease. Initial monotherapy with a dopamine agonist is associated with reduced risk for motor complications in Parkinson patients relative to levodopa. DHEC, like other dopamine agonists, aims to mimic the endogenous neurotransmitter and exert an antiparkinsonian effect. Recent evidence also supports that dopamine receptor agonists, instead of L-DOPA may slow or prevent the progression of Parkinson's disease.
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Parkinson's disease (PD), or simply Parkinson's is a long-term degenerative disorder of the central nervous system that mainly affects the motor system. The symptoms usually emerge slowly and, as the disease worsens, non-motor symptoms become more common. The most obvious early symptoms are tremor, rigidity, slowness of movement, and difficulty with walking. Cognitive and behavioral problems may also occur with depression, anxiety, and apathy occurring in many people with PD. Parkinson's disease dementia becomes common in the advanced stages of the disease. Those with Parkinson's can also have problems with their sleep and sensory systems. The motor symptoms of the disease result from the death of cells in the substantia nigra, a region of the midbrain, leading to a dopamine deficit. The cause of this cell death is poorly understood, but involves the build-up of misfolded proteins into Lewy bodies in the neurons. Collectively, the main motor symptoms are also known as "parkinsonism" or a "parkinsonian syndrome".
The Eating Disorder Inventory (EDI) is a self-report questionnaire used to assess the presence of eating disorders, (a) anorexia nervosa both restricting and binge-eating/purging type; (b) bulimia nervosa; and (c) eating disorder not otherwise specified including binge eating disorder. The original questionnaire consisted of 64 questions, divided into eight subscales. It was created in 1984 by David M. Garner and others. There have been two subsequent revisions by Garner: the Eating Disorder Inventory-2 (EDI-2) and the Eating Disorder Inventory-3 (EDI-3).
The International Parkinson and Movement Disorder Society (MDS) is a professional society of clinicians, scientists, and other healthcare professionals who are interested in movement disorders. The field of Movement Disorders includes the following areas: Parkinson's disease and parkinsonism, ataxia, dystonia, chorea and Huntington's disease, tics and Tourette syndrome, myoclonus and startle, restless leg syndrome, stiff person syndrome, tremor and essential tremor, spasticity, and gait disorders.
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The International Cooperative Ataxia Rating Scale (ICARS) is an outcome measure that was created in 1997 by the Committee of the World Federation of Neurology with the goal of standardizing the quantification of impairment due to cerebellar ataxia. The scale is scored out of 100 with 19 items and 4 subscales of postural and gait disturbances, limb ataxia, dysarthria, and oculomotor disorders. Higher scores indicate higher levels of impairment.
The REM Sleep Behavior Disorder Screening Questionnaire (RBDSQ) is a specific questionnaire for rapid eye movement behavior disorder (RBD) developed by Stiasny-Kolster and team, to assess the most prominent clinical features of RBD. It is a 10-item, patient self-rating instrument with short questions to be answered by either 'yes' or 'no'. The validity of the questionnaire was studied by researchers and they have observed it to perform with high sensitivity and reasonable specificity in the diagnosis of RBD.
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Sue Ellen Leurgans is a biostatistician known for her work on disorders of human movement, including those caused by occupational injury and Parkinson's disease. She is a professor of neurological sciences at the Rush University Medical Center in Chicago.
The Schwab and England ADL scale is a method of assessing the capabilities of people suffering from impaired mobility. Originally presented at a Parkinson's disease conference, the scale assesses the difficulties patients have completing daily activities or chores. The scale uses percentages to represent how much effort and dependence on others patients need complete daily chores. The rating may be given by a professional or by the person being tested.