Department of Neurological Sciences and Neuromed Institute, Sapienza University of Rome, Rome, Italy.
Mov Disord. 2010 Jul 15;25(9):1131-42. doi: 10.1002/mds.23072.
Drug-induced dyskinesia is a common phenomenon in Parkinson's disease (PD) and is often socially as well as physically disabling for patients. The Movement Disorders Society commissioned a task force to assess available clinical rating scales, critique their clinimetric properties, and make recommendations regarding their clinical utility. A task force composed six clinical researchers who systematically searched the literature for scales measuring dyskinesia in PD, evaluated the scales' previous use, performance parameters, and quality of validation data (if available). A scale was designated "Recommended" if the scale has been used in clinical studies beyond the group that developed it, has been specifically used in PD reports, and if clinimetric studies have established that it is a valid, reliable, and sensitive. "Suggested" scales met two of the above criteria and those meeting one were "Listed." Based on the systematic review, eight rating scales for dyskinesia that have either been validated or used in PD were identified. These were the Abnormal Involuntary Movement Scale (AIMS), The Unified Parkinson's Disease Rating Scale (UPDRS) part IV, the Obeso Dyskinesia Rating Scale, the Rush Dyskinesia Rating Scale, the Clinical Dyskinesia Rating Scale (CDRS), the Lang-Fahn Activities of Daily Living Dyskinesia Scale, the Parkinson Disease Dyskinesia Scale (PDYS-26), and the Unified Dyskinesia Rating Scale (UDysRS). Based on this review, at present two of the reviewed dyskinesia scales (AIMS and the Rush Dyskinesia Rating Scale) fulfill criteria for Recommended for use in PD populations, albeit weakly so; all of the remaining met criteria to be Suggested. However, the two most recent scales (PDYS-26 and UDysRS) have excellent clinimetric properties and appear to provide a reliable and valid assessment tool of dyskinesia in PD. If they are used successfully beyond the groups that developed them, both have the potential to be re-ranked as Recommended. As further testing of these scales in PD is warranted, no new scales are needed until the available scales are fully tested clinimetrically.
药物诱导的运动障碍是帕金森病（PD）的常见现象，常使患者在身体和社交方面致残。运动障碍协会委托一个工作组评估现有的临床评估量表，评估其临床计量特性，并就其临床实用性提出建议。一个由 6 名临床研究人员组成的工作组系统地搜索了衡量 PD 运动障碍的量表文献，评估了这些量表的先前使用情况、性能参数和验证数据的质量（如果有的话）。如果一个量表不仅在开发它的小组之外的临床研究中得到了使用，而且在 PD 报告中也得到了专门使用，并且临床计量学研究已经证实它是有效、可靠和敏感的，那么这个量表就被指定为“推荐”。“建议”量表符合上述两个标准中的两个，而符合一个标准的则为“列入”。基于系统评价，确定了 8 种经过验证或用于 PD 的运动障碍评定量表。这些量表是异常不自主运动量表（AIMS）、统一帕金森病评定量表（UPDRS）第 IV 部分、Obeso 运动障碍评定量表、Rush 运动障碍评定量表、临床运动障碍评定量表（CDRS）、Lang-Fahn 日常生活活动障碍量表、帕金森病运动障碍量表（PDYS-26）和统一运动障碍评定量表（UDysRS）。基于这项审查，目前有两种经过审查的运动障碍量表（AIMS 和 Rush 运动障碍评定量表）符合 PD 人群使用的推荐标准，但支持力度较弱；其余的量表都符合被建议的标准。然而，最近的两种量表（PDYS-26 和 UDysRS）具有极好的临床计量特性，似乎为 PD 中的运动障碍提供了可靠和有效的评估工具。如果它们在开发它们的小组之外成功使用，那么它们都有可能被重新列为推荐。鉴于这些量表在 PD 中的进一步测试是必要的，在对现有量表进行全面的临床计量学测试之前，不需要新的量表。
