The Parkinson's Disease Composite Scale Is Adequately Responsive to Acute Levodopa Challenge

Dávid Pintér; Pablo Martinez-Martin; József Janszky; Norbert Kovács

doi:10.1155/2019/1412984

The Parkinson's Disease Composite Scale Is Adequately Responsive to Acute Levodopa Challenge

Parkinsons Dis. 2019 Sep 10:2019:1412984. doi: 10.1155/2019/1412984. eCollection 2019.

Authors

Dávid Pintér¹, Pablo Martinez-Martin², József Janszky^{3

4}, Norbert Kovács^{3

4}

Affiliations

¹ Doctoral School of Clinical Neuroscience, University of Pécs, Pécs, Hungary.
² National Center of Epidemiology, Carlos III Institute of Health, Madrid, Spain.
³ Department of Neurology, Medical School, University of Pécs, Pécs, Hungary.
⁴ MTA-PTE Clinical Neuroscience MR Research Group, Pécs, Hungary.

Abstract

Background: The Parkinson's Disease Composite Scale (PDCS) is a recently developed easy-to-use tool enabling a timely but comprehensive assessment of Parkinson's disease (PD)-related symptoms. Although the PDCS has been extensively validated, its responsiveness to acute levodopa challenge has not been demonstrated yet.

Objective: To investigate the correlation between changes in the motor examination part of the Movement Disorder Society-sponsored Unified Parkinson's Disease Rating Scale (MDS-UPDRS) and the PDCS motor scores during acute levodopa challenge and calculate a cutoff range on the PDCS indicating clinically relevant improvement.

Methods: A consecutive series of 100 patients with parkinsonism were assessed using the motor examination sections of the MDS-UPDRS and the PDCS at least 12 hours after the last levodopa dose and after the administration of a single dose of a suprathreshold immediate formulation of levodopa/benserazide reaching the "best ON." Results. There was a high correlation between changes in the MDS-UPDRS and the PDCS motor scores (Spearman's rho = 0.73, p < 0.001). Receiver operating characteristic analysis revealed that a 14.6%-18.5% improvement in the PDCS motor scores corresponds to a 20-30% improvement in the MDS-UPDRS motor examination.

Conclusions: The PDCS can reliably and adequately respond to an acute levodopa challenge. Any improvements in PDCS motor scores exceeding the 14.6-18.5% threshold could represent a clinically relevant response to levodopa.