Abstract Details

Title Multiple Sclerosis Functional Composite vs. UPDRS: Which Is the More Sensitive Measure in PD?

Topic Movement Disorders

Presentation(s) P04 - (-)

Poster/Presentation
Number 188

Objective

Background BACKGROUND: The standard outcome measure in PD, the motor UPDRS, is based on the neurologic exam. The MSFC combines 3 physical performance measures to assess dexterity, gait, and cognition. This pilot study evaluated the sensitivity of the MSFC to detect differences in PD severity based on Hoehn and Yahr (HY) stages.

Design/Methods DESIGN/METHODS: 35 PD patients were assessed with the motor UPDRS, HY staging, and MSFC [25-foot timed walk (25TW), 9 Hole Peg Test (9HPT), and the Paced Auditory Serial Addition Test (PASAT)]. Because the PASAT has been poorly tolerated, the Symbol Digit Modalities Test (SDMT) was co-administered to examine its effectiveness as an alternative cognitive measure. To calculate the MSFC scores, Z-scores were used based on means from the National MS Database.

Results RESULTS: The subjects (74% M, mean age 64.4(7.5) Y) were divided into 3 subgroups: mild (HY 1-2; N=14), moderate (HY 2.5-3; N=11) and severe PD (HY 4-5; N=10). Based on ANOVA, the scores on the Total MSFC, the 9HPT, the PASAT and the Motor UPDRS significantly differed across the 3 PD severity subgroups (all p<.001). The 25TW showed a trend toward a difference (p=.08). Based on post-hoc t-tests, the only measure that significantly discriminated between all 3 subgroups was the Total MSFC (all p<.05). When the SDMT was substituted for the PASAT, the results were similar: SDMT ratings differed across all 3 groups (p<.001), and Total MSFC score calculated with SDMT (instead of PASAT) discriminated between the three groups (p<.05).

Conclusions CONCLUSIONS: This study shows that the composite physical performance measure used in MS (MSFC) was more sensitive in differentiating levels of PD severity than the motor UPDRS, and may be a more useful clinical measure.

Authors/Disclosures
Katherine Holmes PRESENTER	No disclosure on file
Kathleen Healey, PhD, NP (University of Nebraska Medical Center)	No disclosure on file
Chelsea D. Morrow	No disclosure on file
Ann Gruber-Baldini	No disclosure on file
Stephen G. Reich, MD, FAAN (Univ of MD Hospital/Dept of Neuro)	Dr. Reich has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Best Doctors. Dr. Reich has received personal compensation in the range of $500-$4,999 for serving as a Consultant for UpToDate. Dr. Reich has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Various law firms. Dr. Reich has received publishing royalties from a publication relating to health care. Dr. Reich has received publishing royalties from a publication relating to health care.
Karen Anderson	No disclosure on file
William J. Weiner, MD	No disclosure on file
Lisa M. Shulman, MD, FAAN (University of Maryland School of Medicine)	The institution of Dr. Shulman has received research support from NIH. Dr. Shulman has received publishing royalties from a publication relating to health care. Dr. Shulman has received publishing royalties from a publication relating to health care.
Richard A. Rudick, MD, FAAN (Optimal Brain Health Consultants)	Dr. Rudick has received personal compensation for serving as an employee of Biogen. Dr. Rudick has received stock or an ownership interest from Biogen. Dr. Rudick has received publishing royalties from a publication relating to health care.

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