Abstract
Parkinson’s disease (PD) is a complicated disease in which a number of theoretical and practical considerations on how best to assess the clinical deficit have been published [1–3]. In addition, the utilization of levodopa or dopamine agonists produces a large array of side effects which superimpose upon the motor fluctuations frequently seen in these patients, complicating even more the precise evaluation of disability. Since the introduction of levodopa, a number of clinical rating systems have been suggested and continue to be developed, suggesting that no single scale is completely satisfactory (Table 1). These scales attempt to measure symptoms, signs, and/or functional disability. Subjective methods of assessment of PD include: (a) clinical rating scale, (b) self-rating scale, and (c) functional disability. Simple objective methods include: (a) gait measurements, (b) finger movements, (c) reaction time (computerized), and (d) movement time (computerized). In the present paper, it is our purpose to review the Hoehn and Yahr scale [4], published in 1967, which is the most popular scale used worldwide for the staging of the functional disability associated with Parkinson’s disease.
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References
Marsden CD, Schachter M (1981) Assessment of extrapyramidal disorders. Br J Clin Pharmacol 11:129–151
Larsen AT, LeWitt PA, Came DB (1983) Theoretical and practical issues in assessment of deficits and therapy in parkinsonism. In: Calne DB, Horowski R, McDonald RJ, Wittke W (eds) Lisuride and other dopamine agonists. Raven, New York, pp 363–373
Ward CD, Sanes JN, Dambriosia JM, Calne DB (1983) Methods for evaluating treatment in Parkinson’s disease. In: Fahn S, Calne DB, Shoulson I (eds) Experimental therapeutics of movement disorders. Raven, New York, pp 1–7 (Advances in neurology, vol 37)
Hoehn MM, Yahr MD (1967) Parkinsonism: onset, progression and mortality. Neurology 17:427–442
Fahn S (1975) “On off” phenomenon with levodopa therapy in parkinsonism. Neurology (Minneapolis) 24:431–444
LeWitt PA, Chase TN (1983) “On off” effects: the new challenge in parkinsonism. TINS 6:1–4
Nausieda PA, Glantz R, Weber S, Baum R, Klawans HL (1984) Psychiatric complications of levodopa therapy of Parkinson’s disease. In: Hassler RG, Christ JF (eds) Advances in neurology, vol 40. Raven, New York, pp 271–277
Korczyn AD, Inzelberg R, Treves M, Reider I, Rabey JM (1986) Dementia of Parkinson’s disease. In: Yahr MD, Bergmann KJ (eds) Parkinson’s disease. Raven, New York, pp 399–403 (Advances in neurology, vol 45)
Rabey JM, Scharf M, Oberman Z, Zohar M, Graff E (1990) Cortisol, ACTH and beta endorphin after dexamethasone administration in Parkinson’s dementia. Biol Psychiatry 27:581–591
Mayeux R, Stern Y, Cote L, Williams JBW (1983) Clinical and biochemical features of depression in Parkinson’s disease. Ann Neurol 14:135–136
Fahn S, Elton RL and members of the UPDRS development committee (1987) Unified Parkinson’s disease rating scale. In: Fahn S, Marsden CD, Goldstein M, Calne DB (eds) Recent developments in Parkinson’s disease, vol 2. Macmillan, New York, pp 153–163
Karnofsky DA, Burchenal JH, Armistead GC, Southam CM, Bernstein JL, Craver IF, Rhoads CP (1951) Triethylene nealamine in the treatment of neoplastic disease. Arch Intern Med 87:477–516
England AC, Schwab RS (1956) Postoperative evaluation of 26 selected patients with Parkinson’s disease. J Am Geriatr Soc 4:1219–1232
Canter CJ, De la Torre R, Mier M (1961) A method of evaluating disability in patients with Parkinson’s disease. J Nerv Ment Dis 133:143–147
Webster DD (1968) Critical analysis of the disability in Parkinson’s disease. Mod Treatment 5:257–282
Alba A, Trainor FS, Ritter W, Dacso MM (1968) A clinical disability rating for parkinsonian patients. J Chronic Dis 21:507–522
Klawans HL, Garvin JS (1969) Treatment of parkinsonism with levodopa. Dis Nerv Syst 30:737–746
Duvoisin RC (1970) The evaluation of extrapyramidal disease. In: De Ajuriagerra J (ed) Monoamines, noyaux gris centraux et syndrome de Parkinson. Masson, Paris, pp 313–325
Parkes JD, Zilkha KJ, Calver DM, Knill-Jones RP (1970) Controlled trial of amantadine hydrochloride in Parkinson’s disease. Lancet I:259–262
Cotzias GC, Papavasilou PS, Fehling C, Kaufman B, Mena I (1970) Similarities between neurologic effects of L-dopa and apomorphine. N Engl J Med 282:31–33
Rinne UK, Sonninen V, Sirtola J (1970) L-dopa treatment in Parkinson’s disease. Eur Neurol 4:348–369
McDowell F, Lee JE, Swift T, Sweet RD, Ogsbury JS, Tesslet JT (1970) Treatment of Parkinson’s syndrome with dihydroxyphenylalanine (L-dopa). Ann Intern Med 72:29–35
Anden NE, Carlsson A, Kerstell J, Magnusson T, Olsson R, Roose BE, Steen B, Steg G, Svangorg A, Thieme G, Werdinius B (1970) Oral L-dopa treatment of parkinsonism. Acta Med Scand 187:247–255
Treciokas LJ, Ansel RD, Markham CH (1971) One to two years’ treatment of Parkinson’s disease with levodopa. Calif Med 114:7–16
Birkmayer W, Neumayer E (1972) Die moderne medikamentöse Behandlung des Parkinsonismus. Z Neurol 202:257–264
Potvin AR, Tourtellotte WW (1975) The neurological examination: advancement in its quantification. Arch Phys Med Rehabil 56:425–437
Lhermitte F, Agid Y, Signoret JL (1978) Onset and end-of-dose levodopa induced dyskinesia. Possible treatment by increasing the daily dose of levodopa. Arch Neurol 35:261–263
Diamond DG, Markham CH, Treciokas LJ (1978) A double-blind comparison of levodopa, Madopar and Sinemet in Parkinson’s disease. Ann Neurol 3:267–272
Lieberman A, Dziatolowski M, Gopinathan G, Kupersmith M, Neophytides A, Korein J (1980) Evaluation of Parkinson’s disease. In: Goldstein M (ed) Ergot compounds and brain function: neuro-endocrine and neuropsychiatric aspects. Raven, New York, pp 277–286
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Rabey, J.M., Korczyn, A.D. (1995). The Hoehn and Yahr Rating Scale for Parkinson’s Disease. In: Przuntek, H., Kraus, P.H., Klotz, P., Korczyn, A.D. (eds) Instrumental Methods and Scoring in Extrapyramidal Disorders. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-78914-4_2
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DOI: https://doi.org/10.1007/978-3-642-78914-4_2
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