Un instrumento para la evaluación cuantitativa de los síntomas en la enfermedad de Parkinson idiopática definida

Abstract

To determine the reliability of a clinical quantitative instrument for assessing the symptoms of Defined Idiopathic Parkinson Disease (DIPD). From 148 patients with parkinsonism syndrome, the best 62 EPID cases, according to Calne et al (1992), and Larsen et al (1994) criteria--37 males and 25 females--were selected. The age mean was 68.4 (7.4) year-old, the age of onset was 64 (7.2) years, the time of evolution was 4.3 (2.9) years. 98.4% of the sample was in 1 to 3 Hoehn and Yahr clinical state. Right parkinsonism score (RPS) was 8.2 (4.2), and left (LPS) was 6.7 (4.8). Significant differences between right and left tremor, rigidity and dyskinesia scores were found (ji-squared, p < 0.05). Total parkinsonism score (TPS) was 14 (6.9). Several significant and high correlated coefficients were found between most of the scale's components and Hoehn and Yahr clinical state, TPS, and time of evolution (r > 0.40, p < 0.0001). Total 21 items scale Cronbach's alpha coefficient was 0.92. A stepwise multiple regression model showed that rigidity, postural reflex disorder, and micrography were able to predict the Hoehn and Yahr clinical state (81.4%, p < 0.0001). A principal component analysis showed that akinesia explained more than 59% of the instrument variance, while micrography only explained 0.57% of the variance (100 time lesser). A reliability structure of the instrument was demonstrated for assessing parkinsonism symptoms in DIPD subjects.