First Standardized Measurement Scale For Dyskinesia In Parkinson's Patients
Being Developed By Neurologists
Main Category: Parkinson's Disease News
 Article Date: 18 Jul 2006 - 0:00am (PDT)
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 Two neurologists have been awarded $134,000 to develop the first
comprehensive clinical scale to accurately measure the presence and severity
of dyskinesia (involuntary, uncontrolled movements) in patients with
Parkinson's Disease (PD.)

 "The development of a Unified Dyskinesia Rating Scale will provide a critical
research tool for any future clinical trial," says Dr. Christopher G. Goetz,
Director of Movement Disorders of Rush University Medical Center, who along
with Dr. John G. Nutt, Oregon Health and ScienceUniversity, are working to
develop the rating scale.

 Goetz says that without a comprehensive scale, current clinical trials make
use of many disparate scales that rely on different types of clinical
assessments. "The lack of a Unified Dyskinesia Rating Scale makes it
difficult to compare results across research studies and decreases the
robustness of clinical trials testing dyskinesia treatments."

 When it comes to measuring a new therapy's effects on dyskinesias -- the
involuntary, uncontrollable, and excessive movements that are a common side
effect of drugs used to treat Parkinson's Disease-- different clinicians
observing the same evidence can potentially come to very different
conclusions. No standardized and comprehensive tool exists to make the
judgment easier.

 "Dyskinesias have such a large impact on patients' day-to-day lives that
nearly every Parkinson's clinical trial measures them -- even trials that
don't explicitly involve a dyskinesia therapy," said Katie Hood, the Michael
J. Fox Foundation's (MJFF) vice president of research programs, one of the
two research funding agencies. "But the resulting body of evidence lacks
cohesion because there is no common set of metrics for reporting on
dyskinesias. Practitioners agree on the strong need for a 'common language'
if we are to successfully address this difficult complication of Parkinson's
treatment."

 Dyskinesiascan be lurching, dance-like or jerky and are distinct from the
rhythmic tremor commonly associated with Parkinson's DISEASE.. Hood says they
are a research priority for the MJFF because patients often cite them as one
of the most disabling aspects of living with the disease.

 Goetz and Nutt have already consolidated elements of existing dyskinesia
scales into a working draft of the unified scale. Funding from the MJFF will
allow this draft to be finalized, tested and presented to the movement
disorder community.

 The validation studies will be done in several steps. The researchers must
first test the consistency and reliability of the scale. To do this, they
will videotape examinations of about 70 Parkinson's patients with varying
dyskinesia severity levels. The videotapes will be distributed to clinician
raters along with a preliminary version of the scale, which the clinicians
will use to rate the taped patients' dyskinesias. Goetz and Nutt will look
for variations in the raters' scores on these identical cases to refine the
scale and the instructions for using it.

 The physicians will then prepare a teaching tape for widespread distribution
to clinicians.

 The teaching tape will include segments featuring at least four patients at
each level of dyskinesia severity. The teaching tape will have an "answer
key" -- ratings made by three internationally recognized dyskinesia experts.
Clinicians learning to use the scale will be able to watch the tape, make
their own assessments, and then compare their ratings to the experts'.

 ###

 The researchers plan to present the Unified Dyskinesia Rating Scale, together
with all instructions and teaching tools for its use, to the movement
disorder community by early 2008.

 The Michael J. Fox Foundation (MJFF) has awarded the researchers $84,000 and
EMD Pharmaceutic has given $50,000 in funding.

 Contact: Mary Ann Schultz
 Rush University Medical Center

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