title: Validation of the UPDRS section IV for detection of motor fluctuations in Parkinson's disease.
abstract: The UPDRS-IV represents the most common screening tool to assess motor fluctuations in patients with PD despite the lack of a clinimetric validation.
  
  
  
  We evaluated sensitivity and specificity of UPDRS-IV using a 12-h waking-day motor assessment as the gold standard.
  
  
  
  We consecutively enrolled PD patients who underwent a 12-h waking-day motor assessment in the study. Patients were clinically evaluated every 2 h for 12 h using the UPDRS-III. Motor scores were reported as a line graph and six blinded raters classified patients as having or not having motor fluctuations. The UPDRS-IV was used in order to assess the presence of predictable and unpredictable motor fluctuations according to items 36-38.
  
  
  
  Sixty two PD patients were enrolled in the study. According to the raters' evaluations, 39 (62.9%) were classified as having motor fluctuations, while according to the UPDRS-IV 47 (75.8%) presented a motor fluctuation giving a sensitivity of 87.2% (95%CI 72.6-95.7) and a specificity of 43.5% (95%CI 23.2-65.5).
  
  
  
  Our study results confirm the high level of sensitivity with a lower level of specificity of UPDRS-IV to screen motor fluctuations in PD patients.
authors.affiliation: Section of Neurosciences, Department GF Ingrassia, University of Catania, Catania, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Raciti
authors.affiliation: Section of Neurosciences, Department GF Ingrassia, University of Catania, Catania, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Nicoletti
authors.affiliation: Section of Neurosciences, Department GF Ingrassia, University of Catania, Catania, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Mostile
authors.affiliation: Section of Neurosciences, Department GF Ingrassia, University of Catania, Catania, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Bonomo
authors.affiliation: Section of Neurosciences, Department GF Ingrassia, University of Catania, Catania, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Contrafatto
authors.affiliation: Section of Neurosciences, Department GF Ingrassia, University of Catania, Catania, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Dibilio
authors.affiliation: Section of Neurosciences, Department GF Ingrassia, University of Catania, Catania, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Luca
authors.affiliation: Section of Neurosciences, Department GF Ingrassia, University of Catania, Catania, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Sciacca
authors.affiliation: Section of Neurosciences, Department GF Ingrassia, University of Catania, Catania, Italy.
authors.forename: C E
authors.initials: CE
authors.lastname: Cicero
authors.affiliation: Section of Neurosciences, Department GF Ingrassia, University of Catania, Catania, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Vasta
authors.affiliation: Section of Neurosciences, Department GF Ingrassia, University of Catania, Catania, Italy. Electronic address: m.zappia@unict.it.
authors.forename: M
authors.initials: M
authors.lastname: Zappia
mesh_terms: D000368:Aged; D018491:Dopamine Agonists / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007980:Levodopa / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D019957:Motor Skills Disorders / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology*; D010300:Parkinson Disease / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology*; D012720:Severity of Illness Index; D016037:Single-Blind Method
chemical_list: D018491:Dopamine Agonists; D007980:Levodopa
keywords: Motor fluctuations; Sensitivity and specificity; UPDRS