Ocjenske ljestvice za Parkinsonovu bolest

master's thesis

• Title (english): Rating scales for Parkinson's disease
• Author: Elizabet Deljak
• Mentor: Srđana Telarović (mentor)
• Committee member: Zdravka Poljaković (predsjednik povjerenstva)
• Committee member: Mario Habek (član povjerenstva)
• Committee member: Srđana Telarović (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Neurology); Zagreb
• Defense date and country: 2019-07-12, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Neurology

Abstract

Parkinsonova bolest (PB) je druga najčešća neurodegenerativna bolest obilježena karakterističnim simptomima i znakovima parkinsonizma koji nastaju kao posljedica propadanja dopaminergičkih neurona u supstanciji nigri i posljedičnog manjka dopamina. Glavni motorički simptomi PB uključuju bradikinezu, tremor, rigor i posturalnu nestabilnost. Osim motoričkih, za PB je karakterističan širok spektar nemotoričkih simptoma poput depresije, demencije, poremećaja govora, poremećaja spavanja te autonomne disfunkcije. Dijagnoza PB je klinička, temeljena na prisutnim znakovima parkinsonizma, a slikovne metode kao što su pozitronska emisijska tomografija (eng. positron emission tomography – PET) ili jednofotonska emisijska kompjutorizirana tomografija (eng. single photon emission computed tomography – SPECT) koriste se za potvrdu dijagnoze i razlikovanje PB od drugih sličnih bolesti. Liječenje PB je simptomatsko pa su kontrola motoričkih simptoma i poboljšanje kvalitete života bolesnika osnovni terapijski ciljevi.
Ocjenske ljestvice imaju važnu ulogu u kliničkoj praksi jer omogućuju procjenu stupnja težine bolesti, praćenje i predviđanje daljnjeg razvoja bolesti te procjenu učinkovitosti terapije za svakog bolesnika posebno. Općenito se one mogu podijeliti na one koje se odnose na motoričke manifestacije te na one koje ocjenjuju ne motoričke simptome. Međutim, najbolje rezultate i precizan uvid u zdravstveno stanje bolesnika moguće je dobiti tek njihovom kombinacijom. Najpoznatija i najkorištenija među njima je tzv. Jedinstvena ocjenska ljestvica za procjenu PB (eng. the Unified Parkinson's Disease Rating Scale – UPDRS) koja ocjenjuje i motoričke i nemotoričke simptome. Za nju je provedeno najviše kliničkih ispitivanja koja dokazuju njezinu visoku unutarnju konzistentnost i pouzdanost, umjerenu do dobru valjanost te stabilnu strukturu. Osim UPDRS sličnu valjanost i pouzdanost još pokazuju Hoehn-Yahrova (HY) i Schwab-Englandova ljestvica (SE-ADL).

Abstract (english)

Parkinson's disease (PD) is the second most common neurodegenerative disease characterized by classical motor features of parkinsonism associated with the loss of dopaminergic neurons in the substantia nigra and dopamine deficiency. The classical motor symptoms of PD include bradykinesia, rest tremor, muscular rigidity and postural impairment. Apart from the typical motor symptoms, PD is characterized by a wide range of different non-motoric symptoms like depression, dementia, speech disorders, sleep disorders and autonomic dysfunction. Clinical diagnosis of PD is based on the presence of parkinsonian motor features and dopaminergic imaging with positron emission tomography (PET) or single photon emission computed tomography (SPECT) are used to confirm the diagnosis and to distinguish PD from other similar diseases. Available medications for PD only treat symptoms of the disease trying to control motor features and to improve the quality of life of patients.
Parkinson’s rating scales have an important role in clinical practice. They are used to assess the degree of disease-related disability, for monitoring and predicting further progression of the disease and to help to evaluate the efficiency of the therapeutic procedures. Generally, they can be divided into those related to motor manifestations and to those evaluating non-motoric symptoms. However, the best results and an accurate insight into the patient's health condition can only be obtained by their combination. The most well established and widely used rating scale is the Unified Parkinson's Disease Rating Scale – UPDRS, which combines elements of both motor and nonmotor scales. Many clinical trials have proven that the UPDRS demonstrates high internal consistency and reliability, shows moderate to good validity and has a stable factor structure. The second two most used rating scales are the Hoehn-Yahr Scale (HY) and Schwab and England Scale (SE-ADL), which demonstrate similar validity and reliability as the UPDRS.

• Keywords: Parkinsonova bolest; ocjenske ljestvice; UPDRS (Unified Parkinson's Disease Rating Scale); procjena; onesposobljenost
• Keywords (english): Parkinson's disease; rating scales; UPDRS (Unified Parkinson's Disease Rating Scale); assessment; disability
• Language: croatian
• URN:NBN: urn:nbn:hr:105:295972
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2019-10-23 11:16:11