Screening Mild and Major Neurocognitive Disorders in Parkinson’s Disease

Lucza, Tivadar; Karádi, Kázmér; Kállai, János; Weintraut, Rita; Janszky, József; Makkos, Attila; Komoly, Sámuel; Kovács, Norbert

doi:10.1155/2015/983606

Cited by 49 publications

(47 citation statements)

References 61 publications

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“…The presence of mild and major neurocognitive disorders was based on the Hungarian validated Montreal Cognitive Assessment cutoff scores (<23.5 and <20.5, respectively) [21,22]. PD-related symptoms were assessed by the Hungarian validated version of MDS-UPDRS [23] and the Hoehn-Yahr Stage (HYS) [24].…”

Section: Methodsmentioning

confidence: 99%

Changes in Quality of Life in Parkinson's Disease: How Large Must They Be to Be Relevant?

et al. 2017

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Background: Minimal clinically important difference (MCID) is the smallest change in an outcome, which a patient identifies as meaningful. Although the 2 most frequently applied Parkinson's disease (PD) “quality of life” questionnaires (the PDQ-39 and PDQ-8) provide encouragingly similar results, their MCID thresholds appear to be vastly different. Our aim was to calculate the MCID estimates for both PDQ-39 and PDQ-8 Summary Indices (PDQ-39-SI and PDQ-8-SI) by the utilization of both anchor- and distribution-based techniques. Methods: Nine hundred eighty-five paired investigations of 365 patients were included. Three different techniques were used simultaneously to calculate the MCID values. Results: First, we replicated the previously published results demonstrating how both PDQ-39-SI and PDQ-8-SI provide similar values and respond in a similar way to changes. Subsequently, we calculated the MCID thresholds. The most optimal estimates for MCID thresholds for PDQ-39-SI were -4.72 and +4.22 for detecting minimal clinically important improvement and worsening. For PDQ-8-SI, these estimates were -5.94 and +4.91 points for detecting minimal clinically important improvement and worsening respectively. Conclusions: Our study is the first one that directly compared the MCID estimates for both PDQ-39-SI and PDQ-8-SI on a large pool of patients including all disease severity stages. These MICD estimates varied across PD severity.

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Section: Methodsmentioning

confidence: 99%

Changes in Quality of Life in Parkinson's Disease: How Large Must They Be to Be Relevant?

et al. 2017

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“…The presence of dementia was screened by the simultaneous application of the Mini-Mental State Examination (MMSE) [9], Montreal Cognitive Assessment (MoCA) [10], and the diagnostic criteria of DSM-IV-TR for dementia [8]. The threshold for detecting dementia in PD is ≤22 points on the Hungarian validated version of the MoCA [11,12,13] and ≤26 points on the MMSE [9]. …”

Section: Methodsmentioning

confidence: 99%

High-Frequency Repetitive Transcranial Magnetic Stimulation Can Improve Depression in Parkinson's Disease: A Randomized, Double-Blind, Placebo-Controlled Study

et al. 2016

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Background: A recent evidence-based guideline demonstrated that bilateral repetitive transcranial magnetic stimulation (rTMS) over the motor cortex (M1) can improve motor symptoms of Parkinson's disease (PD). We conducted a randomized, double-blind, placebo-controlled study to evaluate the impact of bilateral M1 rTMS on depression in PD. Methods: Forty-six patients with PD and mild-to-moderate depression were randomly assigned to active (n = 23) and sham (n = 23) rTMS. Two patients in the sham group did not complete the protocol because of reasons unrelated to the study. High-frequency rTMS was applied over the primary motor cortex bilaterally for 10 days. An investigator blinded to the treatment performed three video-taped examinations on each patient: before stimulation (baseline), and 1 day (short-term effect) and 30 days after the treatment session ended (long-term effect). The primary end point was the changes in depression, while secondary end points included health-related quality of life scales and Movement Disorders Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS). Results: In the actively treated group, not only did the severity of depression improve (from 17 to 7 points, Montgomery-Åsberg Depression Rating Scale, median values, p < 0.001), but also the health-related quality of life (from 25.4 to 16.9 points, PDQ-39 summary index, median values, p < 0.001). Besides, we could also demonstrate an improvement in MDS-UPDRS Motor Examination (from 26 to 20 points, median values, p < 0.05). In the sham-treated group, none of the examined tests and scales improved significantly after treatment. Conclusions: Our results demonstrate the beneficial effects of high-frequency bilateral M1 rTMS on depression and health-related quality of life in PD. However, this effect of rTMS should also be confirmed in patients with severe depression by further clinical trials.

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“…Presence of dementia was defined as either having scores ≤125 points on Mattis Dementia Rating Scale (n=427) 13 and/or scores ≤22 points on Montreal Cognitive Assessment (n=537) [14][15][16] . Patients received their usual antiparkinsonian and other medication during the assessments.…”

Section: Patientsmentioning

confidence: 99%

Independent validation of Parkinson’s disease Sleep Scale 2nd version (PDSS-2)

Kovács

Horváth

Aschermann

et al. 2015

Sleep Biol. Rhythms

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Sleep problems are one of the most common non-motor symptoms of Parkinson's disease (PD). The Parkinson's disease Sleep Scale 2 nd version (PDSS-2) was published in 2011 showing satisfactory clinimetric results. We performed an independent testing of the scale adding further information on its clinimetric properties.In this nationwide study 537 PD patients were enrolled. Besides PDSS-2, we assessed Patient's Global Impression-Severity (PGI) scale on sleep disturbances, Non-motor Symptoms Scale and MDS-UPDRS.Following the Classical Theory of Tests we performed descriptive data analysis, factor analysis, reliability, validity and precision measurements. Subsequently, we evaluated cut-off value for detecting clinically meaningful sleep problems based on receiver operating characteristics analysis.Based on the PGI scale, 161 patients (30.0%) did not reported any sleep problems. Factor analysis revealed almost the same factor structure described by the original PDSS-2 validation study. Cronbach's alpha was 0.863 and all item had good item-total correlation. PDSS-2 demonstrated high convergent validity with Non-Motor Symptoms Scale and Clinical Global Impression-Severity and non-motor part of MDS-UPDRS, and divergent validity with age, gender, education-level, disease-duration and Hoehn-Yahr Stages.Presence of sleep problems was identified by scores >10.5 points on PDSS-2 (sensitivity: 85.3%, specificity: 60.8%, diagnostic accuracy: 78.1%); whereas scores >19.5 points indicated marked sleep-related problems (specificity: 68.5%, sensitivity: 78.0%, diagnostic accuracy: 74.3%).Independent and cross-cultural validation of patient reported outcomes is essential to confirm or reject the findings obtained by the developers of the scale. Our results demonstrate that fundamental clinimetric properties of the PDSS-2 are satisfactory.

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Screening Mild and Major Neurocognitive Disorders in Parkinson’s Disease

Cited by 49 publications

References 61 publications

Changes in Quality of Life in Parkinson's Disease: How Large Must They Be to Be Relevant?

Changes in Quality of Life in Parkinson's Disease: How Large Must They Be to Be Relevant?

High-Frequency Repetitive Transcranial Magnetic Stimulation Can Improve Depression in Parkinson's Disease: A Randomized, Double-Blind, Placebo-Controlled Study

Independent validation of Parkinson’s disease Sleep Scale 2nd version (PDSS-2)

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