1. Axial motor clues to identify atypical parkinsonism: A multicentre European cohort study
- Author
-
Carlijn D.J.M. Borm, Florian Krismer, Gregor K. Wenning, Klaus Seppi, Werner Poewe, Maria Teresa Pellecchia, Paolo Barone, Erik L. Johnsen, Karen Østergaard, Tanya Gurevich, Ruth Djaldetti, Luisa Sambati, Pietro Cortelli, Igor Petrović, Vladimir S. Kostić, Hana Brožová, Evžen Růžička, Maria Jose Marti, Eduardo Tolosa, Margherita Canesi, Bart Post, Jorik Nonnekes, Bastiaan R. Bloem, Maria Stamelou, Vladimir S. Kostic, Thomas Klockgether, Richard Dodel, Michael Abele, Wassilios Meissner, Heinz Reichmann, Tim Lynch, Jaroslaw Slawek, Mag Klaus Seppi, Daniela Berg, Joaquim Ferreira, Henry Houlden, Niall P. Quinn, Håkan Widner, Alexander Gerhard, Karla Maria Eggert, Alberto Albanese, Francesca del Sorbo, Maria T. Pellecchia, Bas Bloem, Carlijn Borm, Alfredo Berardelli, Carlo Colosimo, Jose Berciano, Latchezar Traykov, Nir Giladi, Olivier Rascol, Monique Galitzky, Thomas Gasser, Borm, Carlijn D.J.M., Krismer, Florian, Wenning, Gregor K., Seppi, Klau, Poewe, Werner, Pellecchia, Maria Teresa, Barone, Paolo, Johnsen, Erik L., Østergaard, Karen, Gurevich, Tanya, Djaldetti, Ruth, Sambati, Luisa, Cortelli, Pietro, Petrović, Igor, Kostić, Vladimir S., Brožová, Hana, Růžička, Evžen, Marti, Maria Jose, Tolosa, Eduardo, Canesi, Margherita, Post, Bart, Nonnekes, Jorik, Bloem, Bastiaan R., Stamelou, Maria, Kostic, Vladimir S., Klockgether, Thoma, Dodel, Richard, Abele, Michael, Meissner, Wassilio, Reichmann, Heinz, Lynch, Tim, Slawek, Jaroslaw, Klaus Seppi, Mag, Berg, Daniela, Ferreira, Joaquim, Houlden, Henry, Quinn, Niall P., Widner, Håkan, Gerhard, Alexander, Eggert, Karla Maria, Albanese, Alberto, Sorbo, Francesca del, Pellecchia, Maria T., Bloem, Ba, Borm, Carlijn, Berardelli, Alfredo, Colosimo, Carlo, Berciano, Jose, Traykov, Latchezar, Giladi, Nir, Rascol, Olivier, Galitzky, Monique, and Gasser, Thomas
- Subjects
Adult ,Male ,0301 basic medicine ,medicine.medical_specialty ,Neurology ,Parkinson's disease ,Tandem gait ,Atypical parkinsonian disorder ,Progressive supranuclear palsy ,Cohort Studies ,Diagnosis, Differential ,03 medical and health sciences ,Atypical parkinsonian disorders ,0302 clinical medicine ,Physical medicine and rehabilitation ,Atrophy ,Parkinsonian Disorders ,Humans ,Medicine ,Postural instability and gait disability ,Parkinsonian type ,Prospective Studies ,Prospective cohort study ,Postural Balance ,Gait Disorders, Neurologic ,Aged ,Aged, 80 and over ,business.industry ,Parkinson Disease ,Multiple system atrophy ,Middle Aged ,medicine.disease ,Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3] ,Europe ,030104 developmental biology ,Geriatrics and Gerontology ,Neurology (clinical) ,Female ,Differential diagnosis ,business ,030217 neurology & neurosurgery ,Cohort study - Abstract
Item does not contain fulltext OBJECTIVE: Differentiating Parkinson's disease (PD) from atypical parkinsonian disorders (APD) such as Multiple System Atrophy, parkinsonian type (MSA-p) or Progressive Supranuclear Palsy (PSP-RS) can be challenging. Early signs of postural Instability and gait disability (PIGD) are considered clues that may signal presence of APD. However, it remains unknown which PIGD test - or combination of tests - can best distinguish PD from APD. We evaluated the discriminative value of several widely-used PIGD tests, and aimed to develop a short PIGD evaluation that can discriminate parkinsonian disorders. METHODS: In this multicentre cohort study patients were recruited by 11 European MSA Study sites. Patients were diagnosed using standardized criteria. Postural instability and gait disability was evaluated using interviews and several clinical tests. RESULTS: Nineteen PD, 21 MSA-p and 25PSP-RS patients were recruited. PIGD was more common in APD compared to PD. There was no significant difference in axial symptoms between PSP-RS and MSA-p, except for self-reported falls (more frequent in PSP-RS patients). The test with the greatest discriminative power to distinguish APD from PD was the ability to perform tandem gait (AUC 0.83; 95% CI 71-94; p
- Published
- 2018
- Full Text
- View/download PDF