Natural History Of Updrs Motor Scores In An Observational Parkinson'S Disease Cohort

Objective: This study estimated the annual rate of change on The United Parkinson9s Disease Rating Scale (UPDRS) motor section in Parkinson9s disease (PD) patients and assessed the influence of early-onset PD on motor progression. Background The UPDRS is the standard clinical measure of PD motor symptoms. Most data describing the rate of change on the UPDRS are derived from clinical trials or other interventional studies (e.g. DATATOP). More data is needed from studies with broad inclusion criteria. Design/Methods: Idiopathic PD patients were enrolled in longitudinal study consisting of biannual motor, cognitive, and psychiatric assessments. The UPDRS motor section was rated in the off state. Random effect models estimated the rate of change in UPDRS motor scores per year of disease duration controlling for age, sex, education, and depression. An interaction term for young-onset PD ( Results: On average patients were 67.4 years old (SD 10.5), had PD for 9.6 (6.7) years, and were followed for 3.0 years (3.0; Min-Max 0-10). Thirty-five patients (22.4%) had young-onset PD. Total UPDRS motor scores increased by 1.2 points/year (SE 0.2). The bradykinesia subscore increased by 0.4 points/year (0.07), the rigidity subscore increased by 0.2 points/year (0.05), and the axial subscore increased by 0.3 points/year (0.04). The tremor subscore increased by 0.02 points/year (0.05), but the slope was not statistically significant. Early-onset PD was associated with a decreased rate of change in axial symptoms [-.2 points/year (0.07)], but was not associated with a differential rate of change on the total motor score or other subscores. Conclusions: The average UPDRS motor score increase was 1.2 points/year; however, tremor scores did not change over time. This study suggests that young-onset PD is associated with milder axial symptoms but does not support the notion of an overall milder disease course in young-onset patients. Supported by: NINDS grant P50-NS-58377 (the Morris K. Udall Parkinson9s Disease Research Center of Excellence at Johns Hopkins) and NIA grant T32-AG-027668 (Williams). Disclosure: Dr. Williams has received personal compensation for activities with Biogen Idec and Johns Hopkins University as an employee. Dr. Mari has received personal compensation for activities with Teva, Merz, and Ipsen. Dr. Mari has received research support from Merz, Allergan, and PharmaNet. Dr. Pontone has received research support from The Michael J. Fox Foundation, EMD (Merck) Serono, and Acadia Pharmaceuticals. Dr. Bassett has nothing to disclose.