Patients’ Self-reported Symptoms Reflect Clinical Assessments of Parkinson’s Severity, Study Finds

A patient’s perception of how Parkinson’s disease affects their motor and non-motor skills reflects clinical assessments of disease severity, a study has found.

The findings of the study were presented in the poster, “Modeling the Effect of Patient’s Perception of Non-Motor and Motor Function on Parkinson’s Disease Severity,” during the recent International Congress of Parkinson’s Disease and Movement Disorders, in Nice, France.

In recent years, worldwide regulatory and clinical health authorities have been increasingly interested in evaluating the link between patient-reported outcomes and clinicians’ assessments of Parkinson’s severity.

“Understanding the specific self-reported non-motor and motor functional impairments that contribute to PD [Parkinson’s disease] severity is important to treatment efforts,” the researchers wrote.

These researchers from Rush University set out to determine whether a patient’s perception of how Parkinson’s affected their motor and non-motor skills would match the conclusions of healthcare professionals who assessed disease severity using clinically objective criteria.

To that end, investigators analyzed data from 6,684 patients with Parkinson’s disease that were pooled from the international Movement Disorder Society-Sponsored Revision of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) Translation database.

These data contained information from patient-reported impairments in non-motor (Part I) and motor (Part II) categories. These outcomes (assessed in Part I and II) were used to create models of overall disease severity, as objectively measured by healthcare professionals (MDS-UPDRS Part III).

The team created two different models: one focused on patient-reported non-motor outcomes and the other focused on patient-reported motor outcomes. Statistical analyses demonstrated that both models conveyed important information to assess disease severity, as independently measured by examiners in Part III.

In the non-motor model, 10 different categories were found to be important measures of disease severity, including urinary function, cognitive impairment, constipation, hallucinations and psychosis, fatigue, apathy, depression,  daytime sleepiness, pain, and light-headedness.

In the motor model, 13 different categories were considered relevant measures of disease severity, including tremor, walking and balance, getting out of bed, hygiene, handwriting, turning in bed, speech, eating, saliva and drooling, “freezing” of gait, dressing, chewing and swallowing, and hobbies.

The researchers noted that, based on these two models, a patient’s perception of motor function seemed superior to their perception of non-motor function.

“This is an important piece of research coming from a world-renowned group and objectively defines what is now considered the benchmark concept of Parkinson’s disease (PD), that it is effectively as much a non-motor disorder as it is motor, the latter being the traditionally defined concept of this fastest growing neurodegenerative disorder in the world,” K. Ray Chaudhuri, professor of movement disorders and clinical director of the National Parkinson Foundation Centre of Excellence at Kings College in London, said in a news release.

“The researchers were able to show that self-reporting of motor and importantly, non-motor symptoms can successfully be used to construct a severity model of PD,” Chaudhuri added. “This research supports the importance and validity of combining motor and non-motor measurements of PD in terms of grading disease severity as can be done using the MDS-UPDRS.”