Supine MDS-UPDRS-III Assessment: An Explorative Study.

Area of Science:

• Neurology
• Movement Disorders
• Clinical Assessment

Background:

• The Movement Disorder Society Unified Parkinson's Disease Rating Scale-part III (MDS-UPDRS-III) is standardly administered in a sitting position.
• Clinical scenarios like neurosurgery or assessing bedridden Parkinson's disease (PD) patients necessitate supine assessments.
• Evaluating the validity of the supine MDS-UPDRS-III is crucial for accurate PD patient evaluation.

Purpose of the Study:

• To explore the agreement between MDS-UPDRS-III scores obtained in sitting and supine positions.
• To assess the reliability and correlation with objective measures (accelerometry) in both positions.
• To provide recommendations for the use of MDS-UPDRS-III in supine assessments.

Main Methods:

• Administered the MDS-UPDRS-III to 23 PD patients in both sitting and supine positions.
• Simultaneously recorded accelerometric data to objectively measure motor function.
• Analyzed agreement using Cohen's kappa and assessed tremor scores against accelerometry via linear regression.

Main Results:

• Found fair to substantial agreement for individual items and substantial agreement for the total score between sitting and supine positions.
• Observed fair to moderate inter-rater reliability in both positions.
• Identified a logarithmic relationship between tremor scores and accelerometric amplitude in both positions.

Conclusions:

• While overall agreement exists, the supine MDS-UPDRS-III is not fully endorsed for all individual items due to inter-rater variability.
• Caution is recommended when interpreting supine MDS-UPDRS-III scores pending further research.
• Further studies are needed to refine and validate the supine application of the MDS-UPDRS-III for Parkinson's disease assessment.