Experience in the use of a multimodal staging system for Parkinson’s disease in clinical practice

Abstract

Objective. The aim of the study was to evaluate the information content of the multimodal staging system for Parkinson’s disease in clinical practice. Material and methods. The study was conducted on the basis of the Regional Clinical Hospital (Odesa). 364 patients with Parkinson’s disease were examined. Clinical manifestations were assessed according to the recommendations of Levin O.A. et al. (2019). Outcomes. Average age of the patients was 64.6±0.5 years, the sample was dominated by men – the gender ratio was 1/1.14. Left-sided lesions were noted in 126 (34.6%) patients, right-sided – in 127 (34.9%), bilateral – in 111 (30.5%). The akinetic-rigid form was observed in 92 (25.3%) cases, trembling – in 27 (7.4%) cases, mixed rigid-trembling in 157 (43.1%) cases, tremulous-rigid in 92 (7.4%) cases). Stage 1 according to Hoehn-Yahr was determined in 33 (9.1%), stage 1.5 – in 58 (15.9%), stage 2 – in 104 (28.6%), stage 2.5 – in 36 (9.9%), stage 3 - in 102 (28.0%), stage 3.5 – in 6 (1.6%), stage 4 – in 25 (6.9%) cases. No cases of stage 5 were reported. 65.4% of patients had cognitive impairments. 121 (33.2%) patients had pain syndrome of varying severity. Vegetative manifestations of varying severity were observed in 201 (55.2%) patients, affective manifestations – in 170 (46.7%) patients. Conclusion. The MOSCOVA scale is advisable to detail the criteria for staging within motor and non-motor manifestations of PD.