Objective: To present validation results of the Movement Disorder Society Non-Motor Symptoms Scale (MDS-NMS), originally developed for Parkinson’s disease, for use in people with Huntington’s disease (PwHD).

Background: Non-motor symptoms are increasingly recognised as major contributors to disease burden and progression in HD. They may occur at different disease stages and can precede motor onset by several years. Currently, no dedicated instrument exists to assess non-motor symptoms in PwHD. Therefore, the MDS-NMS, validated in Parkinson’s disease, was selected as a foundation scale.

Method: We conducted a cross-sectional study of PwHD (HD-ISS 1–3) and healthy volunteers, administering the MDS-NMS for validation. Before data collection, and following consultation with clinicians, HD experts, and PwHD, minor adaptations were made to the scale. PwHD (n=34; mean age 50.3±11.23) and controls (n=21; mean age 50.29±11.1) completed the rater-administered MDS-NMS. Psychometric validation included acceptability (floor/ceiling effects), dimensionality (exploratory factor analysis using principal axis factoring), and internal consistency (Cronbach’s α). Group differences in non-motor symptoms were then examined

Results: Following expert advice, question E4 and the NM-fluctuations subscale were deemed unsuitable for PwHD. No ceiling effects were observed, although floor effects varied across subdomains (24–91%). Internal consistency was high (Cronbach’s α≥0.880). Factor analysis showed adequate sampling (KMO=0.769; Bartlett’s p<.001). The scree plot supported a three-factor solution with communalities ranging from 0.349–0.959. Mann–Whitney U tests showed significant group differences between PwHD and controls in anxiety, apathy, impulse control, cognition, urinary, gastrointestinal, sleep, pain, other symptoms, and MDS-NMS total scores. However, only anxiety, sleep, other symptoms, and total scores remained significant after correction for multiple comparisons (p<0.001)

Conclusion: The MDS-NMS demonstrated validity for assessing non-motor symptoms in PwHD in clinical settings. PwHD showed impairments across cognitive, behavioural, and systemic domains that may contribute to functional burden and caregiver strain. Systematic use of this scale in primary care could potentially improve patients’ quality of life

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MDS Abstracts - https://www.mdsabstracts.org/abstract/non-motor-symptoms-in-huntingtons-disease-results-from-the-validation-of-the-non-motor-symptoms-scale-mds-nms/