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An Objective Fluctuation Score for Parkinson's Disease

Artikel i vetenskaplig tidskrift
Författare M. K. Horne
S. McGregor
Filip Bergquist
Publicerad i Plos One
Volym 10
Nummer/häfte 4
Sidor e0124522
ISSN 1932-6203
Publiceringsår 2015
Publicerad vid Institutionen för neurovetenskap och fysiologi, sektionen för farmakologi
Sidor e0124522
Språk en
Länkar dx.doi.org/10.1371/journal.pone.012...
Ämnesord MOTOR FLUCTUATIONS, LEVODOPA, EVOLUTION, PHARMACODYNAMICS, THERAPY, Multidisciplinary Sciences
Ämneskategorier Farmakologi

Sammanfattning

Introduction Establishing the presence and severity of fluctuations is important in managing Parkinson's Disease yet there is no reliable, objective means of doing this. In this study we have evaluated a Fluctuation Score derived from variations in dyskinesia and bradykinesia scores produced by an accelerometry based system. Methods The Fluctuation Score was produced by summing the interquartile range of bradykinesia scores and dyskinesia scores produced every 2 minutes between 0900-1800 for at least 6 days by the accelerometry based system and expressing it as an algorithm. This Score could distinguish between fluctuating and non-fluctuating patients with high sensitivity and selectivity and was significant lower following activation of deep brain stimulators. The scores following deep brain stimulation lay in a band just above the score separating fluctuators from non-fluctuators, suggesting a range representing adequate motor control. When compared with control subjects the score of newly diagnosed patients show a loss of fluctuation with onset of PD. The score was calculated in subjects whose duration of disease was known and this showed that newly diagnosed patients soon develop higher scores which either fall under or within the range representing adequate motor control or instead go on to develop more severe fluctuations. The Fluctuation Score described here promises to be a useful tool for identifying patients whose fluctuations are progressing and may require therapeutic changes. It also shows promise as a useful research tool. Further studies are required to more accurately identify therapeutic targets and ranges.

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