Abstract
Introduction: The Munich Dysphagia Test for Parkinson's disease (MDT-PD) was initially developed and validated in the German population as a highly sensitive and specific self-reported screening questionnaire to detect early oropharyngeal symptoms and aspiration risk in patients with idiopathic Parkinson's disease (iPD). In order to make this tool accessible for prevention in the French speaking populations worldwide, we performed the first French translation and provide a linguistic and psychometric validation in the unique multilingual environment of the Luxembourg Parkinson's Study.Methods: We performed the translation of the MDT-PD into French according to WHO guidelines and subsequently performed the linguistic validation including native speakers. For psychometric validation, 46 patients with parkinsonism from Luxembourg and the Greater Region without severe cognitive impairment were recruited in the frame of the Luxembourg Parkinson's Study. All patients were fluent in French and German completed the MDT-PD in both languages (three times in total).Results: Linguistic and psychometric validation of the French MDT-PD was reflected by a high test-retest (10/26 questions with K > 0.6 and 10/26 with 0.4 < K ≤ 0.6) and language reliability (12/26 K > 0.6 and 8/26 0.4 < K ≤ 0.6), with an internal consistency for the French (Cronbach's alpha 0.84) and German version (0.87); strong item collinerarity strengthens the internal consistency. No significant differences between MDT-PD score distribution and clinical parameters assessing, for example, disease progression, motor state, or cognition has been observed.Conclusion: Based on a multilingual approach in the Luxembourg Parkinson Study, we validated the translation of the first French MDT-PD as a non-invasive tool for early detection of dysphagia in patients with parkinsonism. The unexpectedly high number of positively screened patients at earlier disease stages indicate options for new prevention strategies in large French speaking populations worldwide. Diagnostic validation using clinical and endoscopic swallowing evaluation will be continued soon.
Highlights
The Munich Dysphagia Test for Parkinson’s disease (MDT-PD) was initially developed and validated in the German population as a highly sensitive and specific self-reported screening questionnaire to detect early oropharyngeal symptoms and aspiration risk in patients with idiopathic Parkinson’s disease
The goal of the study was (i) a linguistic and (ii) a psychometric validation of the French version of MDTPD questionnaire assessing test-retest and language reliability properties, and construct validity with the focus on patients diagnosed with PD as well as atypical forms of parkinsonism (aPS)
To be included in the study, all subjects must meet either the UK Parkinson’s Disease Society Brain Bank Clinical Diagnostic Criteria [10, 11] for PD or the criteria defined for the respective atypical forms of parkinsonism, including progressive supranuclear palsy (PSP) [12, 13], multiple system atrophy (MSA) [12], corticobasal syndrome (CBS) [13], or a secondary form of parkinsonism, vascular parkinsonism (VP) [14], based on internationally established criteria
Summary
The Munich Dysphagia Test for Parkinson’s disease (MDT-PD) was initially developed and validated in the German population as a highly sensitive and specific self-reported screening questionnaire to detect early oropharyngeal symptoms and aspiration risk in patients with idiopathic Parkinson’s disease (iPD). In order to make this tool accessible for prevention in the French speaking populations worldwide, we performed the first French translation and provide a linguistic and psychometric validation in the unique multilingual environment of the Luxembourg Parkinson’s Study. Due to an early loss of oropharyngeal sensibility and an impaired self-awareness a pooled prevalence for PD is reported to be 35% (95% CI 28–41) when simple selfassessment was performed, whereas 82% (95% CI 77–87) when objective instrumental measures were taken into account [1]. With respect to the screening results, recommendations and indications for further instrumental diagnostics and appropriate medical therapies can be provided (cf. Supplement 1, Table 1.1 or directly on the MDT-homepage/web application www.mdtparkinson.com)
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