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Rating Parkinson's Disease: A Contemporary Eye to Archival Patients.

ABSTRACT: In this article, we present a detailed analysis of archival films of 12 different patients with Parkinson's disease (PD). This unique collection of films was made by Arthur Van Gehuchten (1861-1914), the first professor of neurology in Belgium at the turn of the 20th century. These extraordinarily well-preserved century-old documents are a precise iconography of PD before encephalitis lethargica swept the world and with clinical features unaffected by treatments such as levodopa. In view of the universal interest of the International Parkinson and Movement Disorder Society-sponsored revision of the UPDRS (MDS-UPDRS) in evaluating patients with PD, we based our analysis on this scale. Of course, given the lack of detailed clinical files and the impossibility of rating a number of items, rating disease severity in a strict clinimetric sense could not be achieved. However, we did this exercise in order to place these one-century-old cases in a modern perspective. In most patients, we could score numerous items of the motor examination part of the MDS-UPDRS. These archival documents constitute a superb lesson in the semiology of PD, which keeps today its fresh didactical value.

SUBMITTER: Jeanjean AP

PROVIDER: S-EPMC6353416 | biostudies-literature | 2014 Sep

REPOSITORIES: biostudies-literature

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Rating Parkinson's Disease: A Contemporary Eye to Archival Patients.

Jeanjean Anne P AP Aubert Genevieve G

Movement disorders clinical practice 20140731 3

In this article, we present a detailed analysis of archival films of 12 different patients with Parkinson's disease (PD). This unique collection of films was made by Arthur Van Gehuchten (1861-1914), the first professor of neurology in Belgium at the turn of the 20th century. These extraordinarily well-preserved century-old documents are a precise iconography of PD before encephalitis lethargica swept the world and with clinical features unaffected by treatments such as levodopa. In view of the ...[more]

PMID: 30713854

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Project description: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.

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Rating Parkinson's Disease: A Contemporary Eye to Archival Patients.

Publications

Rating Parkinson's Disease: A Contemporary Eye to Archival Patients.

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