Staging Parkinson's disease according to the MNCD (Motor/Non-motor/Cognition/ Dependency) classification correlates with disease severity and quality of life
Keywords: 
Axial symptoms
MNCD classification
Cognition
Non-motor symptoms
Parkinson’s disease
Quality of life
Issue Date: 
2023
Project: 
info:eu.repo/grantAgreement/MINECO/Proyectos de investigación en salud (Modalidad Proyectos de investigación en salud) (AE Salud 2016)/PI16%2F01575/ES/Estudio integral de los biomarcadores implicados en el desarrollo y evolución de la enfermedad de Parkinson
ISSN: 
1877-7171
Note: 
This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (CC BY-NC 4.0).
Citation: 
Santos-Garcia, D.; de Deus Fonticoba, T.; Cores Bartolome, C.; et al. "Staging Parkinson's disease according to the MNCD (Motor/Non-motor/Cognition/ Dependency) classification correlates with disease severity and quality of life". Journal of parkinson`s disease. 13 (3), 2023, 379 - 402
Abstract
Background: Recently, a novel simple classification called MNCD, based on 4 axes (Motor; Non-motor; Cognition; Dependency) and 5 stages, has been proposed to classify Parkinson's disease (PD). Objective: Our aim was to apply the MNCD classification in a cohort of PD patients for the first time and also to analyze the correlation with quality of life (QoL) and disease severity. Methods: Data from the baseline visit of PD patients recruited from 35 centers in Spain from the COPPADIS cohort from January 2016 to November 2017 were used to apply the MNCD classification. Three instruments were used to assess QoL: 1) the 39-item Parkinson's disease Questionnaire [PDQ-39]); PQ-10; the EUROHIS-QOL 8-item index (EUROHIS-QOL8). Results: Four hundred and thirty-nine PD patients (62.05 +/- 7.84 years old; 59% males) were included. MNCD stage was: stage 1, 8.4% (N = 37); stage 2, 62% (N = 272); stage 3, 28.2% (N = 124); stage 4-5, 1.4% (N = 6). A more advanced MNCD stage was associated with a higher score on the PDQ39SI (p < 0.0001) and a lower score on the PQ-10 (p < 0.0001) and EUROHIS-QOL8 (p < 0.0001). In many other aspects of the disease, such as disease duration, levodopa equivalent daily dose, motor symptoms, non-motor symptoms, and autonomy for activities of daily living, an association between the stage and severity was observed, with data indicating a progressive worsening related to disease progression throughout the proposed stages. Conclusion: Staging PD according to the MNCD classification correlated with QoL and disease severity. The MNCD could be a proper tool to monitor the progression of PD.

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