The Non‐Motor Symptoms Scale in Parkinson’s disease: Validation and use

Abstract

The Non‐Motor Symptoms Scale (NMSS) was developed and validated in 2007 as the first instrument for the comprehensive assessment of a range of non‐motor symptoms in Parkinson's disease (PD). Thirteen years have elapsed since its introduction and extensive international validation with good psychometric attributes has been carried out. Here, we review the validation data of the NMSS and its cross‐validity with other scales, and describe the key evidence derived from use of the NMSS in clinical studies. To date, over 100 clinical studies and trials have made use of it as an outcome measure, showing consistent and strong correlations between NMSS burden and health‐related quality of life measures. Moreover, the scale has shown to be capable of detecting longitudinal changes in non‐motor symptoms, where studies have shown differential changes over time of several of the NMSS domains. The scale has become a key outcome in several randomized clinical trials. Highlighting the prevalence and importance of non‐motor symptoms to quality of life in patients with PD, the development of NMSS has also been useful in signposting clinical and biomarker based research addressing non‐motor symptoms in PD.

Characterization of dementia with Lewy bodies (DLB) and mild cognitive impairment using the Lewy body dementia module (LBD‐MOD)

“…Individuals with more impaired cognition may take longer. Autonomic and constitutional features were captured by a checklist of 23 features derived in part from the Non‐Motor Symptoms Scale 43 and Scales for Outcomes in Parkinson's Disease‐Autonomic Dysfunction (SCOPA‐AUT) 44 used in studies of Parkinson's disease. The checklist rates the presence and absence of sialorrhea, dysphagia, libido and sexual performance, unplanned weight loss, changes in taste and smell, hyperhidrosis, cold and heat intolerance, double vision, gastroparesis, constipation, obstipation, incomplete emptying of the bladder, urinary frequency and strength of urination, bowel and bladder incontinence, orthostatic hypotension, and syncope.…”

Gastrointestinal Dysfunction in Parkinson’s Disease

“…A wide range of NMS in PD arise from the gastrointestinal tract and several questionnaires have been developed to quantify the symptoms including the Scales for Outcomes in Parkinson’s Disease—Autonomic [ 19 , 46 ] (SCOPA-AUT), the Non-Motor Symptoms Scale [ 47 , 48 ] (NMSS) and the Non-motor Symptoms Questionnaire [ 49 ] (NMSQuest). These are validated for use in PD and all include a section on gastrointestinal symptoms.…”

The impact of COVID-19 on palliative care for people with Parkinson’s and response to future pandemics

“…• Palliative care (PC) prioritizes quality of life (QoL) and focuses on the prevention and relief of physical, emotional and spiritual suffering through a multidisciplinary approach, and in a holistic manner; it is 'patient-centered' rather than 'disease-centered' • The current COVID- 19…”

“…We advocate for the use of validated tools, such as the selfcompleted NMS Questionnaire (NMSQuest), which can be applied remotely and allows for time-efficient staging of NMS burden, while also flagging up particular NMS occurring as an integral part of 'COVID-19 PD Syndrome' that require special attention, both in short-and long-term [18][19][20]. Figure 3.…”