OBJECTIVE CLINICAL EVALUATION OF THE PATIENT WITH PARKINSON’S DISEASE: THE USEFULNESS OF VARIOUS RATING SCALES

Abstract

Assessment of Parkinson's disease (PD) is a complex process as a consequence of the variety of motor and non-motor symptoms as well as treatment complications, that can be present in a patient. A significant number of rating scales and questionnaires, either generic or specific, have been developed for PD clinical assessment. The Unified Parkinson's Disease Rating Scale (UPDRS) has been the ‘gold standard’ during the past 25 years followed by its revised version, the MDS-UPDRS. Gait and balance assessments are important components of a comprehensive motor evaluation. Recommended scales by the Movement Disordes Society (MDS) are the PIGB, Berg Balance Scale, Mini-BESTest, Functional Gait Assessment, Freezing of Gait Questionnaire, Falls Efficacy Scale etc. Treatment complications can be evaluated by means of specific instruments for wearing off screening e.g.,Wearing-Off Questionnaires with either 9 or 19 items as well as various dyskinesia rating scales. A ‘holistic’ approach to non-motor symptoms evaluation can be performed using the Non Motor Symptom Questionnaire or the Non Motor Symptom Scale. There is a large variety of scales designated for the assessment of single non motor symptoms e.g. depression, autonomic impairment, sleep, fatigue, cognitive function etc. Last but not least, measures of health related quality of life (e.g. PDQ-39) are employed to capture the patients’ perspective of the impact of PD upon his/hers wellbeing and social status.