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. 2020 Oct;35(10):1802-1809.
doi: 10.1002/mds.28145. Epub 2020 Jun 22.

A Prospective Validation of the Updated Movement Disorders Society Research Criteria for Prodromal Parkinson's Disease

Nikolaos Giagkou  1 , Maria I Maraki  2   3 , Mary Yannakoulia  2 , Mary H Kosmidis  4 , Efthimios Dardiotis  5 , Georgios M Hadjigeorgiou  5 , Paraskevi Sakka  6 , Eva Ntanasi  2   7 , Costas A Anastasiou  2   7 , Georgia Xiromerisiou  5 , Leonidas Stefanis  7   8 , Nikolaos Scarmeas  7   9 , Maria Stamelou  1   7   10
Affiliations

A Prospective Validation of the Updated Movement Disorders Society Research Criteria for Prodromal Parkinson's Disease

Nikolaos Giagkou et al. Mov Disord. 2020 Oct.

Abstract

Objective: The objective of this study was to validate the recently updated research criteria for prodromal Parkinson's disease (pPD) proposed by the International Parkinson's Disease and Movement Disorders Society.

Methods: A total of 16 of 21 markers of pPD were ascertained in the Hellenic Longitudinal Investigation of Aging and Diet cohort composed of community-dwelling individuals aged ≥65 years. The probability of pPD was calculated for 961 individuals without Parkinson's disease (PD) or dementia with Lewy bodies at baseline who were followed-up for a median of 3 years. The ability of the criteria to predict conversion to PD/dementia with Lewy bodies was assessed by estimating their sensitivity and specificity, plotting receiver operating characteristics curves, and using logistic regression. These analyses were repeated using the original criteria.

Results: No incident PD/dementia with Lewy bodies case had probable pPD at baseline (ie, ≥80% pPD probability). At cut-offs of 10%, 30%, and 50% probability of pPD, the sensitivity and specificity of the criteria ranged from 4.5% to 27.3%, and 85.7% to 98.3% respectively. The area under the receiver operating characteristics curve was 0.691 (95% confidence intervals, 0.605-0.777). In logistic regression models, the criteria-derived posttest odds of pPD were a significant predictor of conversion at follow-up. The updated criteria performed similarly to the original but showed a slight increase in sensitivity.

Conclusions: The new criteria demonstrated suboptimal sensitivity in our random sample of community-dwelling individuals. The absence of specialized assessments with high likelihood ratios in our cohort could be hindering the demonstration of higher sensitivities. Such assessments should be a part of future validation attempts. © 2020 International Parkinson and Movement Disorder Society.

Keywords: Parkinson's disease; cohort; prodromal Parkinson's disease; research criteria.

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References

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