Does MDS-UPDRS Provide Greater Sensitivity to Mild Disease than UPDRS in De Novo Parkinson's Disease?

the SPARX Study Group

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Background: The Movement Disorder Society revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS) was designed to be more sensitive to mild motor severity than the Unified Parkinson's Disease Rating Scale (UPDRS). Objective: To test whether MDS-UPDRS Part III items provide increased sensitivity to mild motor severity when compared to the same items of the UPDRS in de novo PD patients. Method: Using a sample of 129 de novo PD patients assessed at one time point simultaneously with both scales, we compared the scale's scores on the 17 items measuring the same motor function. The scaling anchors for the MDS-UPDRS were Slight, Mild, Moderate and Severe, and for the UPDRS were Mild, Moderate, Severe and Marked. Using Classical Test Theory (CTT) we compared the distributions of the scaling anchors from the individual items. Using Item Response Theory (IRT), we examined the sensitivity of the scaling anchors from each scale to the latent-trait measurement of overall parkinsonian motor severity. Results: There was 2193 observations of individual scaling anchors from the 17 items in both scales. The CTT approach revealed frequent floor effects with only the item assessing Gait demonstrating a significance difference in the scaling distribution between the scales (P = 0.005). The IRT analyses revealed similar levels of sensitivity to the latent trait of PD motor function. Conclusion: These results do not support increased sensitivity of MDS-UPDRS over the UPDRS for assessing mild motor severity in de novo PD patients, with significant difference in the scaling only for the item assessing gait.

Original languageEnglish (US)
Pages (from-to)1092-1099
Number of pages8
JournalMovement Disorders Clinical Practice
Issue number7
StatePublished - Oct 2021


  • Parkinson's disease
  • clinimetrics
  • outcome measures
  • severity of illness index

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology


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