Objective: To describe a sample of Parkinson’s disease (PD) patients by means of a combined, comprehensive, motor and non-motor staging system.

Background: PD severity is globally rated using the Hoehn and Yahr staging (HY), which is mainly based on motor aspects of the disease and disability. A new strategy for clinical classification of PD patients based on the Non-Motor Symptoms Scale (NMSS) severity levels has been recently proposedand can be added to HY for a global PD severity description.

Methods: International, cross-sectional studyof 1307 PD patientsassessed using the HY,the NMSS, the Scales for Outcomes in Parkinson’s disease (SCOPA)-Motor and the Clinical Impression of Severity Index for PD (CISI-PD). Patients were classified using simultaneously the HY and the NMSS severity levels: A=No NMS (score=0); B=Mild (scores 1-20); C=Moderate (21-40); D=Severe (41-70); and E=Very severe (≥71). Descriptive statistics and the mean and standard deviation (SD) of rating scales in the sample grouped by the proposed combined classificationwere calculated.

Results: Patients, aged 65.5 (SD: 10.6), with disease duration of 6.5 (SD: 5.6) years, predominantly male (64.3%), have been assessed. Distribution ofHY stages were:HY1, 19.8%; HY2, 42.3%; HY3, 27.9%; HY4, 8.4%; and HY5, 1.5%.Distribution of NMSS severity levels were: A.No NMS, 0.8%; B.Mild, 26.6%; C.Moderate, 27.6%; D.Severe, 24.1%; and E.Very severe, 20.9%. The highest proportions with the combined classification were: 2C (13.3% of the sample)and 2B (12.9%). Most patients in HY1 were in NMSS stage B.Mild(41.7%); patients in HY2, in NMSS stage C.Moderate (32.3%); patients in HY3 were mostly in NMSS stage E.Very severe (31.5%); patients in HY4, in NMSS stage E.Very severe (45.8%); and 73.7% patients in HY5 were in NMSS stage E.Very severe. SCOPA-Motor, CISI-PD and NMSS scores were significantly higher in the PD patients classified in the more severe stages of the combined system (Kruskal-Wallis test, p<0.01), except for SCOPA-Motor in patients stages 4B to 4E, for who the difference did not reach significant values.

Conclusions: A comprehensive, combined, motor and non-motor staging classification is congruent with the characteristics of the disease, easy to perform, and relevant for clinical practice and research.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/comprehensive-motor-and-non-motor-staging-system-in-parkinsons-disease-results-from-a-global-cross-sectional-study/