On the structure of motor symptoms of Parkinson's disease

This study aims to investigate the structure of the motor symptoms of Parkinson's disease (PD), as measured by the Motor Section of the Unified Parkinson's Disease Rating Scale (UPDRS). The dimensionality of the Motor Section of the UPDRS was studied using structural equation modeling. The UPDRS measures were obtained from 405 patients with PD [237 men (39 "off", 170 "on", 28 unknown) and 168 women (21 "off", 140 "on", 7 unknown)]. The ordinal character of UPDRS scores and sample size substantiated the use of robust diagonally weighted least squares model estimation. It was shown that the Motor Section of the UPDRS incorporates five main latent symptom factors (rigidity, tremor, bradykinesia of the extremities, axial/gait bradykinesia, speech/hypomimia) plus two additional factors for laterality, which account for asymmetry of tremor, rigidity and bradykinesia of the extremities. Tremor seems to be an independent symptom factor of PD. Other latent variables are substantially correlated.