Does <scp>MDS‐UPDRS</scp> Provide Greater Sensitivity to Mild Disease than <scp>UPDRS</scp> in De Novo Parkinson's Disease?
Michelle Hyczy de Siqueira Tosin, Glenn T. Stebbins, Cynthia L. Comella, Charity G. Patterson, Deborah A. Hall, the SPARX Study Group
Abstract
BACKGROUND: The Movement Disorder Society revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS) was designed to be more sensitive to mild motor severity than the Unified Parkinson's Disease Rating Scale (UPDRS). OBJECTIVE: To test whether MDS-UPDRS Part III items provide increased sensitivity to mild motor severity when compared to the same items of the UPDRS in de novo PD patients. METHOD: Using a sample of 129 de novo PD patients assessed at one time point simultaneously with both scales, we compared the scale's scores on the 17 items measuring the same motor function. The scaling anchors for the MDS-UPDRS were Slight, Mild, Moderate and Severe, and for the UPDRS were Mild, Moderate, Severe and Marked. Using Classical Test Theory (CTT) we compared the distributions of the scaling anchors from the individual items. Using Item Response Theory (IRT), we examined the sensitivity of the scaling anchors from each scale to the latent-trait measurement of overall parkinsonian motor severity. RESULTS: = 0.005). The IRT analyses revealed similar levels of sensitivity to the latent trait of PD motor function. CONCLUSION: These results do not support increased sensitivity of MDS-UPDRS over the UPDRS for assessing mild motor severity in de novo PD patients, with significant difference in the scaling only for the item assessing gait.