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Mokken scale analysis of the UPDRS: dimensionality of the Motor Section revisited.

The dimensionality and reliability of the Motor Section of the Unified Parkinson Disease Rating Scale (UPDRS III) was studied with non-parametric Mokken scale analysis. UPDRS measures were obtained on 147 patients with PD (96 men, 51 women, mean age 61, range 35-80 yrs). Mokken scale analysis revealed a four-dimensional structure of the UPDRS III. Left-sided bradykinesia and rigidity appeared to co-occur with axial signs, gait disturbance, and speech/hypomimia, whereas right-sided bradykinesia and rigidity formed a second scale. Two further small scales were found consisting of right- and left-sided tremor. Results from the scale analysis reveal that all four subscales are strong. The reliability of the two tremor scales is low because they only contain three and four items, respectively.