Multiple Sclerosis Functional Composite vs. UPDRS: Which Is the More Sensitive Measure in PD? (P04.188)

OBJECTIVE: To compare the Multiple Sclerosis Functional Composite (MSFC) to the Unified Parkinson9s Disease Rating Scale (UPDRS) in detecting differences in disease severity in Parkinson9s Disease (PD). BACKGROUND: The standard outcome measure in PD, the motor UPDRS, is based on the neurologic exam. The MSFC combines 3 physical performance measures to assess dexterity, gait, and cognition. This pilot study evaluated the sensitivity of the MSFC to detect differences in PD severity based on Hoehn and Yahr (HY) stages. DESIGN/METHODS: 35 PD patients were assessed with the motor UPDRS, HY staging, and MSFC [25-foot timed walk (25TW), 9 Hole Peg Test (9HPT), and the Paced Auditory Serial Addition Test (PASAT)]. Because the PASAT has been poorly tolerated, the Symbol Digit Modalities Test (SDMT) was co-administered to examine its effectiveness as an alternative cognitive measure. To calculate the MSFC scores, Z-scores were used based on means from the National MS Database. RESULTS: The subjects (74% M, mean age 64.4(7.5) Y) were divided into 3 subgroups: mild (HY 1-2; N=14), moderate (HY 2.5-3; N=11) and severe PD (HY 4-5; N=10). Based on ANOVA, the scores on the Total MSFC, the 9HPT, the PASAT and the Motor UPDRS significantly differed across the 3 PD severity subgroups (all p CONCLUSIONS: This study shows that the composite physical performance measure used in MS (MSFC) was more sensitive in differentiating levels of PD severity than the motor UPDRS, and may be a more useful clinical measure. Disclosure: Dr. Holmes has nothing to disclose. Dr. Morrow has nothing to disclose. Dr. Gruber-Baldini has nothing to disclose. Dr. Reich has received royalty payments from Informa Publishers. Dr. Reich has received research support from NINDS, Chiltern, Synosia, and Phytopharm. Dr. Anderson has received personal compensation for activities with Boehringer Ingelheim R11 as a consultant and expert medical exaluation. Dr. Anderson has received personal compensation in an editorial capacity as Section editor for Current Treatment Options in Neurology. Dr. Weiner has received personal compensation for activities with Santhera and Rexahn. Dr. Weiner has received personal compensation in an editorial capacity for Neurological Reviews and Current Treatment Options in Neurology. Dr. Weiner has received research support from Teva Neuroscience, Boehringer-Ingelheim and Merck Serono. Dr. Shulman has received personal compensation for serving as Editor of the AAN Neurology Now patient book series. Dr. Shulman has received research support from the NIH, Fox Foundation and Teva Pharmaceuticals.