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

Nikolaos Giagkou, Maria I Maraki, Mary Yannakoulia, Mary H Kosmidis, Efthimios Dardiotis, Georgios M Hadjigeorgiou, Paraskevi Sakka, Eva Ntanasi, Costas A Anastasiou, Georgia Xiromerisiou, Leonidas Stefanis, Nikolaos Scarmeas, Maria Stamelou

Journal: Movement disorders : official journal of the Movement Disorder Society 2021;35(10):1802-1809

PMID: 32567751

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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.

Address: Parkinson's Disease and Movement Disorders Department, Hygeia Hospital, Athens, Greece.; Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.; Section of Sport Medicine and Biology of Exercise, School of Physical Education and Sport Science, National and Kapodistrian University of Athens, Athens, Greece.; Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.; Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece.; School of Medicine, University of Thessaly, Larissa, Greece.; Athens Association of Alzheimer's Disease and Related Disorders, Marousi, Greece.; Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.; 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece.; 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece.; Center of Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece.; 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece.; Taub Institute for Research in Alzheimer's Disease and the Aging Brain, The Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, New York, New York, USA.; Parkinson's Disease and Movement Disorders Department, Hygeia Hospital, Athens, Greece.; 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece.; School of Medicine, European University of Cyprus, Nicosia, Cyprus.

DOI: 10.1002/mds.28145

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MeSH Terms: Aged, Alzheimer Disease, Cohort Studies, Humans, Parkinson Disease, Prodromal Symptoms, Prospective Studies