SAN DIEGO—For patients with Parkinson’s disease, the Multiple Sclerosis Functional Composite (MSFC) may be a more sensitive measure of disease severity than the Unified Parkinson’s Disease Rating Scale (UPDRS), researchers reported at the 65th Annual Meeting of the American Academy of Neurology. Unlike the UPDRS, the MSFC may differentiate between patients with early, moderate, and advanced Parkinson’s disease.
Lisa M. Shulman, MD, Professor of Neurology at the University of Maryland School of Medicine in Baltimore, and colleagues enrolled 59 patients with Parkinson’s disease in a pilot study that compared the sensitivity of the MSFC with that of the UPDRS. Twenty-one patients had early disease, 20 patients had moderate disease, and 18 had advanced disease, according to Hoehn and Yahr stages. Approximately three-quarters of patients were male, and subjects’ mean age was 66.
Physicians evaluated all participants with the motor UPDRS and the Hoehn and Yahr scale. Patients completed the Montreal Cognitive Assessment and the MSFC, which comprised the Nine-Hole Peg Test (an arm dexterity measure), a timed 25-foot walk (a gait assessment), and the Paced Auditory Serial Addition Test (PASAT), a cognitive measure.
The motor UPDRS significantly distinguished between early and advanced Parkinson’s disease and between moderate and advanced Parkinson’s disease, but did not distinguish between groups with early and moderate Parkinson’s disease.
The Total MSFC (ie, the composite of the three tasks) significantly differentiated between all three groups of disease severity. The three individual components and the Total MSFC showed significant differentiation across the three disease severity groups, but post hoc tests indicated that the individual component measures did not distinguish between moderate and severe Parkinson’s disease. Only the Total MSFC score significantly differentiated between all three groups.
“The MSFC may be a more sensitive measure to use in Parkinson’s disease than the motor UPDRS, particularly when investigating patients with mild to moderate stages of disease,” said Dr. Shulman. She noted that longitudinal studies are needed to confirm these cross-sectional results and suggested the development of a database to standardize MSFC scores in Parkinson’s disease.
—Erik Greb
Senior Associate Editor