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Disability in activities of daily living and severity of dyskinesias determine the handicap of ParkinsonĀ“s disease patients in advanced stage selected to dbs

2017Journal article Restricted access
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dc.contributor.authorCoelho, Miguel
dc.contributor.authorAbreu, Daisy
dc.contributor.authorCorreia-Guedes, Leonor
dc.contributor.authorLobo, PatrĆ­cia Pita
dc.contributor.authorFabbri, Margherita
dc.contributor.authorGodinho, Catarina
dc.contributor.authorDomingos, Josefa
dc.contributor.authorAlbuquerque, Luisa
dc.contributor.authorFreitas, Vanda
dc.contributor.authorPereira, JoĆ£o Miguel
dc.contributor.authorCattoni, Begona
dc.contributor.authorCarvalho, Herculano
dc.contributor.authorReimĆ£o, Sofia
dc.contributor.authorRosa, MƔrio M.
dc.contributor.authorFerreira, AntĆ³nio GonƧalves
dc.contributor.authorFerreira, Joaquim J.
dc.date.accessioned2019-10-10T11:55:43Z
dc.date.available2019-10-10T11:55:43Z
dc.date.issued2017
dc.description.abstract"BACKGROUND: There is scarce data on the level of handicap in Parkinson's disease (PD) and none in advanced stage PD. OBJECTIVE: To assess the handicap in advanced stage PD patients with disabling levodopa-induced motor complications selected to deep brain stimulation (DBS). METHODS: Data was prospectively recorded during routine evaluation for DBS. Handicap was measured using London Handicap Scale (LHS) (0ā€Š=ā€Šmaximal handicap; 1ā€Š=ā€Šno handicap). Disease severity was evaluated using the Hoehn & Yahr scale and the UPDRS/MDS-UPDRS, during off and on after a supra-maximal dose of levodopa. Schwab and England Scale (S&E) was scored in off and on. Dyskinesias were scored using the modified Abnormal Involuntary Movement Scale (mAIMS). Results concern cross-sectional assessment before DBS. RESULTS: 100 PD patients (mean age 61 (Ā±7.6); mean disease duration 12.20 (Ā±4.6) years) were included. Median score of motor MDS-UPDRS was 54 in off and 25 in on. Mean total LHS score was 0.56 (Ā±0.14). Patients were handicapped in several domains with a wide range of severity. Physical Independence and Social Integration were the most affected domains. Determinants of total LHS score were MDS-UPDRS part II off (Ī²=ā€Š-0.271; pā€Š=ā€Š0.020), S&E on (Ī²=ā€Š0.264; pā€Š=ā€Š0.005) and off (Ī²=ā€Š0.226; pā€Š=ā€Š0.020), and mAIMS on (Ī²=ā€Š-0.183; pā€Š=ā€Š0.042) scores (R2 ā€Š=ā€Š29.6%). CONCLUSIONS: We were able to use handicap to measure overall health condition in advanced stage PD. Patients were moderately to highly handicapped and this was strongly determined by disability in ADL and dyskinesias. Change in handicap may be a good patient-centred outcome to assess efficiency of DBS."pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationJournal of Parkinsonā€™s Disease. 2017;7(2):255-261. doi: 10.3233/JPD-160848pt_PT
dc.identifier.doi10.3233/JPD-160848pt_PT
dc.identifier.issn1877-7171
dc.identifier.urihttp://hdl.handle.net/10400.26/29900
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherIOS Presspt_PT
dc.relation.publisherversionThe final publication is available at IOS Press through http://dx.doi.org/10.3233/JPD-160848pt_PT
dc.subjectParkinsonā€™s diseasept_PT
dc.subjectAdvanced stagept_PT
dc.subjectHandicappt_PT
dc.subjectLondon Handicap Scalept_PT
dc.subjectMotor complicationspt_PT
dc.titleDisability in activities of daily living and severity of dyskinesias determine the handicap of ParkinsonĀ“s disease patients in advanced stage selected to dbspt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage261pt_PT
oaire.citation.startPage255pt_PT
oaire.citation.titleJournal of Parkinson's Diseasept_PT
oaire.citation.volume7(2)pt_PT
rcaap.embargofctPolĆ­tica de copyright da editorapt_PT
rcaap.rightsrestrictedAccesspt_PT
rcaap.typearticlept_PT

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