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Dynamic Digital Biomarkers of Motor and Cognitive Function in Parkinson's Disease
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The movement disorder society nonmotor rating scale: Initial validation study.

K Ray Chaudhuri1, Anette Schrag2, Daniel Weintraub3,4

  • 1King's College London, Department of Neurosciences, Institute of Psychiatry, Psychology & Neuroscience and Parkinson Foundation Centre of Excellence, King's College Hospital, Denmark Hill, London, UK.

Movement Disorders : Official Journal of the Movement Disorder Society
|October 2, 2019
PubMed
Summary

The new Movement Disorder Society Nonmotor Rating Scale effectively measures nonmotor symptoms and fluctuations in Parkinson's disease patients. This updated scale demonstrates good reliability and validity for assessing the nonmotor burden in PD.

Keywords:
Parkinson's diseasemovement disordersnonmotor fluctuationsnonmotor symptomsscales

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Area of Science:

  • Neurology
  • Movement Disorders
  • Clinical Assessment Tools

Background:

  • The Movement Disorder Society Nonmotor Rating Scale (MDS-NRS) is an updated version of the Parkinson's disease Nonmotor Symptoms Scale (PD-NMS).
  • It was modified to improve scoring, structure, and symptom coverage compared to the previous scale.
  • This addresses limitations identified in the original PD-NMS.

Purpose of the Study:

  • To evaluate the reliability and validity of the Movement Disorder Society Nonmotor Rating Scale (MDS-NRS) in Parkinson's disease (PD) patients.
  • To assess the scale's ability to measure the burden of nonmotor symptoms and nonmotor fluctuations.
  • To compare the MDS-NRS with existing measures like the Nonmotor Symptoms Scale (NMS) and UPDRS.

Main Methods:

  • An international, multicenter study recruited 402 PD patients.
  • The MDS-NRS, including a subscale for nonmotor fluctuations, was administered by raters alongside other clinical assessments.
  • Standard psychometric testing, including reliability and validity analyses, was performed.

Main Results:

  • The MDS-NRS demonstrated satisfactory data quality, with no significant floor or ceiling effects for total scores.
  • Internal consistency was acceptable (Cronbach's alpha 0.66 for MDS-NRS, 0.84 for fluctuations).
  • Excellent interrater reliability (ICC >0.95) and good test-retest reliability (ICC 0.84 for MDS-NRS, 0.70 for fluctuations) were observed. Scores correlated highly with NMS and UPDRS, and increased with PD duration, severity, and medication.
  • The MDS-NRS is a valid measure for assessing the burden of nonmotor symptoms and fluctuations in PD patients.

Conclusions:

  • The Movement Disorder Society Nonmotor Rating Scale (MDS-NRS) is a valid and reliable tool for assessing nonmotor symptoms in Parkinson's disease.
  • It effectively captures the burden of a wide range of nonmotor symptoms, including fluctuations.
  • The MDS-NRS provides a valuable update for the clinical assessment of Parkinson's disease patients.