帕金森病非运动症状量表心理测量属性的国际研究。

International study on the psychometric attributes of the non-motor symptoms scale in Parkinson disease.

作者信息

Martinez-Martin P, Rodriguez-Blazquez C, Abe K, Bhattacharyya K B, Bloem B R, Carod-Artal F J, Prakash R, Esselink R A J, Falup-Pecurariu C, Gallardo M, Mir P, Naidu Y, Nicoletti A, Sethi K, Tsuboi Y, van Hilten J J, Visser M, Zappia M, Chaudhuri K R

机构信息

National Center of Epidemiology, Carlos III Institute of Health, Av. Monforte de Lemos, 3, 28029 Madrid, Spain.

出版信息

Neurology. 2009 Nov 10;73(19):1584-91. doi: 10.1212/WNL.0b013e3181c0d416.

DOI:10.1212/WNL.0b013e3181c0d416

PMID:19901251

Abstract

BACKGROUND

Nonmotor symptoms (NMS) have a great impact on patients with Parkinson disease (PD). The Non-Motor Symptoms Scale (NMSS) is an instrument specifically designed for the comprehensive assessment of NMS in patients with PD. NMSS psychometric properties have been tested in this study.

METHODS

Data were collected in 12 centers across 10 countries in America, Asia, and Europe. In addition to the NMSS, the following measures were applied: Scales for Outcomes in Parkinson's Disease (SCOPA)-Motor, SCOPA-Psychiatric Complications (SCOPA-PC), SCOPA-Cognition, Hoehn and Yahr Staging (HY), Clinical Impression of Severity Index for Parkinson's Disease (CISI-PD), SCOPA-Autonomic, Parkinson's Disease Sleep Scale (PDSS), Parkinson's Disease Questionnaire-39 items (PDQ-39), and EuroQol-5 dimensions (EQ-5D). NMSS acceptability, reliability, validity, and precision were analyzed.

RESULTS

Four hundred eleven patients with PD, 61.3% men, were recruited. The mean age was 64.5 +/- 9.9 years, and mean disease duration was 8.1 +/- 5.7 years. The NMSS score was 57.1 +/- 44.0 points. The scale was free of floor or ceiling effects. For domains, the Cronbach alpha coefficient ranged from 0.44 to 0.85. The intraclass correlation coefficient (0.90 for the total score, 0.67-0.91 for domains) and Lin concordance coefficient (0.88) suggested satisfactory reproducibility. The NMSS total score correlated significantly with SCOPA-Autonomic, PDQ-39, and EQ-5D (r(S) = 0.57-0.70). Association was close between NMSS domains and the corresponding SCOPA-Autonomic domains (r(S) = 0.51-0.65) and also with scales measuring related constructs (PDSS, SCOPA-PC) (all p < 0.0001). The NMSS total score was higher for women (p < 0.02) and for increasing disease duration, HY, and CISI-PD severity level (p < 0.001). The SEM was 13.91 for total score and 1.71 to 4.73 for domains.

CONCLUSION

The Non-Motor Symptoms Scale is an acceptable, reproducible, valid, and precise assessment instrument for nonmotor symptoms in Parkinson disease.

摘要

背景

非运动症状（NMS）对帕金森病（PD）患者有重大影响。非运动症状量表（NMSS）是专门为全面评估PD患者的NMS而设计的工具。本研究对NMSS的心理测量特性进行了测试。

方法

在美国、亚洲和欧洲10个国家的12个中心收集数据。除NMSS外，还应用了以下测量方法：帕金森病统一评分量表（SCOPA）-运动、SCOPA-精神并发症（SCOPA-PC）、SCOPA-认知、霍恩和雅尔分期（HY）、帕金森病严重程度临床印象指数（CISI-PD）、SCOPA-自主神经、帕金森病睡眠量表（PDSS）、帕金森病问卷-39项（PDQ-39）和欧洲五维健康量表（EQ-5D）。分析了NMSS的可接受性、可靠性、有效性和精确性。

结果

招募了411例PD患者，男性占61.3%。平均年龄为64.5±9.9岁，平均病程为8.1±5.7年。NMSS评分为57.1±44.0分。该量表无地板效应或天花板效应。对于各个领域，克朗巴哈α系数范围为0.44至0.85。组内相关系数（总分0.9, 各领域0.67 - 0.91）和林一致性系数（0.88）表明具有良好的可重复性。NMSS总分与SCOPA-自主神经、PDQ-39和EQ-5D显著相关（斯皮尔曼相关系数r(S)=0.57 - 0.70）。NMSS各领域与相应的SCOPA-自主神经领域密切相关（r(S)=0.51 - 0.65），也与测量相关结构的量表（PDSS、SCOPA-PC）密切相关（所有p<0.0001）。女性的NMSS总分较高（p<0.02），且随着病程、HY分期和CISI-PD严重程度水平的增加而升高（p<0.001）。总分的标准误为13.91，各领域的标准误为1.71至4.73。