Objective: To identify the most important self-reported motor experience predictors of objective measures of motor impairment in patients with Parkinson’s disease (PD).

Background: The MDS-UPDRS has become the most commonly used assessment of PD.  The scale includes a self-report assessment of motor impairment (Part 2: Motor Experiences of Daily Living) and an objective rating of motor impairment (Part 3: Motor Examination).  Although the correlation between Parts 2 and 3 is high (r = 0.66) the relative importance of individual self-reported motor experiences on objective motor impairment has not been investigated.

Methods: We examined the MDS-UPDRS, Parts 2 (Motor Experiences of Daily Living) and Part 3 (Motor Examination) administered in a large cohort (n=994) drawn from two studies: the MDS-UPDRS Clinimetric testing program (CTPS) and the Rush PD-Cognitive Behavioral Imaging study (PD-CBI). The least absolute shrinkage and selection operator (LASSO) regularized regression model was used to identify the most important self-reported motor experiences (Part 2 items) that predict objective motor score (Part 3 total score).

Results: A LASSO regularized regression with bootstrap resampling (100 replications) with optimal LASSO penalty of Lambda=0.62 revealed a significant model with four predictors (F[26,967] 31.95, p<0.0005). The self-reported motor problems with Gait (LASSO coefficient 0.110), Getting out of Bed (LASSO coefficient = 0.106), Eating (LASSO coefficient = 0.081) and Dressing (LASSO coefficient = 0.064) were identified as the most significant predictors of objective motor impairment. This model accounted for approximately 45% of the shared variance. Self-report of Speech, Saliva/Drooling, Chewing/Swallowing, Hygiene, Handwriting, Hobbies, Turning in Bed, Freezing, and Tremor were not significant predictors.

Conclusions: Of the self-reported motor experiences assessed in Part 2 of the MDS-UPDRS, measures of complex motoric function (Gait, Getting out of Bed) and complex motor-dependent ADLs (Eating and Dressing) are the most important predictors of objective ratings of motor impairment. Other, less complex self-reported motor experiences of daily living do not have the same impact on objectively assessed motor impairment.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/which-self-report-motor-experiences-of-daily-living-best-predict-objective-motor-function-in-patients-with-parkinsons-disease/