SENS-PD

In spite of the multisystem nature ofPD, the formal assessment of its impairments is currently focused on symptoms predominantly reflecting degeneration of dopaminergic neurons. The SENS-PD (SEverity of predominantly Nondopaminergic Symptoms in PD) scale was developed to obtain a rating of predominantly non-dopaminergic (PND) symptoms that can be used as an additional measure of severity and progression of PD. Based on item-total correlations, three items were selected from each of six selected PND domains - cognitive impairment, depressive symptoms, excessive daytime sleepiness, psychotic symptoms, autonomic dysfunction and Postural-Instability-and-Gait-Difficulty -, which were identified earlier as a coherent pattern of symptoms from a large pool of motor and non-motor features that reflected the full spectrum of PD. We subsequently showed that a composite score of this PND-complex robustly reflected disease severity and progression of PD. The SENS-PD score is largely insensitive to dopaminergic effects and may therefore more accurately reflect severity and progression of the underlying disease than currently used dopamine-sensitive measures. In combination with assessment of predominantly dopaminergic (i.e., motor) symptoms, a broad yet concise evaluation of PD is obtained, which better captures the widespread clinical consequences of the multisystem disease.