• Glenn T Stebbins, Christopher G Goetz, David J Burn, Joseph Jankovic, Tien K Khoo, and Barbara C Tilley.
• Department of Neurological Sciences, Section of Movement Disorders, Rush University Medical Center, Chicago, IL 60612, USA. gstebbin@rush.edu
• Mov. Disord. 2013 May 1; 28 (5): 668-70.

BackgroundFormulas were developed to define tremor dominant (TD) and postural instability/gait difficulty (PIGD) phenotypes of Parkinson's Disease (PD) using the Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS). TD and PIGD designations, based on the original Unified Parkinson's Disease Rating Scale (UPDRS), provided useful designations for classifying different phenotypes of PD. With the advent of the MDS-UPDRS, a valid set of calculations for these phenotypes is needed.MethodsUPDRS and MDS-UPDRS scores were collected on 877 PD patients. TD/PIGD scores were calculated using the UPDRS formula for all patients. Comparable TD and PIGD items from the MDS-UPDRS were used to calculate new ratios. Data were analyzed using receiver operating characteristic models.ResultsThe new MDS-UPDRS TD/PIGD ratios accounted for a significant area under the curve compared with the UPDRS classification. Optimal sensitivity and specificity were obtained with MDS-UPDRS cutoff scores of ≥1.15 for TD classification and ≤0.90 for PIGD.ConclusionsThe development of comparable and valid PIGD and TD scores from the MDS-UPDRS provides a clear method for clinicians and researchers to transition from the original UPDRS to the new MDS-UPDRS in categorizing patients with different clinical phenotypes. © 2013 Movement Disorder Society.Copyright © 2013 Movement Disorder Society.

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