What is the UPDRS?
The Unified Parkinson’s Disease Rating Scale, or UPDRS, is an assessment tool designed to assist clinicians and researchers in evaluating the severity of Parkinson’s disease a patient is suffering from. It assesses many aspects of motor function, as well as non-motor functions such as cognitive function, mental state, and overall daily living.
There are four parts of the UPDRS. Part 1 assesses mentation, behavior, and mood; part 2 covers activities of daily living; part 3 is a motor examination, and part 4 evaluates complications of therapy. Parts 1-3 are scored on a numerical scale, whereas part 4 is scored on a dichotomous scale using yes/no answers. In total, the 50-question evaluation regularly takes about half an hour and is completed with a physician alongside the patient.
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Utilization of UPDRS in clinical practice and research
The UPDRS is a clinical ‘gold standard’ for monitoring symptom development in Parkinson’s patients. It is a useful tool for identifying symptom onset, as well as symptom progression throughout the patient’s lifetime. The ability to objectively monitor symptom fluctuation also makes it a very useful tool in Parkinson’s research. Neurologists use the UPDRS during clinical trials to evaluate the efficacy of a medication or therapeutic at stalling or reducing symptom progression. The UPDRS can be used in a variety of settings, including inpatient, outpatient, and as part of in-home healthcare regimens.
MDS-UPDRS: recent updates to the UPDRS by the Movement Disorder Society
The UPDRS was originally developed in the 1980s but underwent a more recent update in 2008 by the Movement Disorder Society. This updated version (the MDS-UPDRS) addresses areas of concern from the original UPDRS, including reading comprehension, scoring scales, and organization of the exam.
The original UPDRS utilized a combination of numerical and dichotomous scoring scales, which were updated to a consistent numerical scale for all questions. A great amount of reorganization went into updated evaluation, particularly separating non-motor and motor function evaluations into different sections. In addition, the evaluation was updated to increase emphasis on slight deficits in addition to severe disabilities. There are still four parts to the updated MDS-UPDRS, but they are organized differently. Part 1 evaluates non-motor experiences of daily living; part 2 covers motor experiences of daily living; part 3 is still the motor examination; and part 4 assesses motor complications.
