Background: The Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS) is a newly developed tool to assess Parkinson's disease (PD). Changes in scores on the scale over the course of PD, including increasing disease duration and Hoehn and Yahr (HY) stages, have not been described. The objectives of this study were to analyze MDS-UPDRS scores on Parts I through IV and their differences based on HY stage and disease duration in a large cohort of patients with PD. Methods: For this cross-sectional study, demographic data and MDS-UPDRS scores were collected, including HY stage. Subscores on MDS-UPDRS Parts I through IV were analyzed using 1-way analyses of variance for each HY stage and in 5-year increments of disease duration. Part III (motor assessment) scores were analyzed separately for on and off states. Results: The mean age of the 3206 patients was 65.8 AE 10.6 years, 53.3% were men, the mean disease duration was 11.5 AE 4.6 years, and the median HY stage was 2 (range, 0-5); 2156 patients were examined in

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Background: Pain is a frequent feature in Parkinson's disease (PD). Current knowledge on pain and its associated factors in PD has been obtained using nondisease-specific tools. Recently, the King's Parkinson's Disease Pain Scale (KPPS) was published as the first disease-specific scale. The aim of this study was to assess PD-associated pain and its main determinants using the KPPS. Methods: A cross-sectional study was carried out. Consecutive patients with PD were recruited from a movement disorders clinic. Clinical and demographical data were collected. The KPPS, the Movement Disorders Society Unified Parkinson's Disease Rating Scale, and the Non-Motor Symptoms Scale were used to assess all participants. Results: In total, 314 patients were included. Overall, 88.6% of the sample reported at least 1 type of pain. The mean AE standard KPPS score was 18.8 AE 19.5. Factors associated with higher KPSS scores were female sex (P < 0.001), levodopa treatment (P < 0.001), the presence of depressed mood (P < 0.001), wearing off (P = 0.003), and dyskinesia (P = 0.005). Participants who had postural instability and gait difficulty motor subtypes had higher KPPS scores compared with those who had other subtypes. Multivariate regression analysis showed that only sex, motor subtype, depressed mood, and Non-Motor Symptoms Scale sleep/ fatigue domain scores achieved statistical significance as determinants (all P < 0.01). Conclusion: PD-associated pain is a frequent symptom that tends to increase in both frequency and severity as disease progresses. Risk factors for increased burden include female gender, postural instability and gait difficulty motor subtypes, mood alterations, and sleep/fatigue disturbances.

The identification of reliable biomarkers for early diagnosis and progression tracking of neurodegenerative diseases has become an important objective in clinical neuroscience in the last years. The P3a event-related potential, considered as the neurophysiological hallmark of novelty detection, has been shown to be reduced in Parkinson's disease (PD) and proposed as a sensitive measure for illness duration and severity. Our aim for this study was to explore for the first time whether impaired novelty detection could be observed through phase- and time-locked brain oscillatory activity at early PD. Twenty-seven patients with idiopathic PD at early stages (disease duration <5 years and Hoehn and Yahr stage <3) were included. A healthy control group (n = 24) was included as well. All participants performed an auditory involuntary attention task including frequent and deviant tones while a digital EEG was obtained. A neuropsychological battery was administered as well. Time-frequency representations of power and phase-locked oscillations and P3a amplitudes were compared between groups. We found a significant reduction of power and phase locking of slow oscillations (3–7 Hz) for deviant tones in the PD group compared to controls in the P3a time range (300–550 ms). Also, reduced modulation of late induced (not phase locked) alpha-beta oscillations (400–650 ms, 8–25 Hz) was observed in the PD group after deviant tones onset. The P3a amplitude was predicted by years of evolution in the PD group. Finally, while phase-locked slow oscillations were associated with task behavioral distraction effects, induced alpha-beta activity was related to cognitive flexibility performance. Our results show that novelty detection impairment can be identified in neurophysiological terms from very early stages of PD, and such impairment increases linearly as the disease progresses. Also, induced alpha-beta oscillations underlying novelty detection are related to executive functioning.

This is so far the largest study related to HRQoL issues in PD. Restrictions in activities of daily living and non-motor symptoms significantly contribute to HRQoL in PD.