Validation of the Arabic Version of the Movement Disorder Society-Unified Parkinson's Disease Rating Scale.

BACKGROUND: The Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) has become the gold standard for evaluating different domains in Parkinson's disease (PD), and it is commonly used in clinical practice, research, and clinical trials. OBJECTIVES: The objectives are to validate the Arabic-translated version of the MDS-UPDRS and to assess its factor structure compared with the English version. METHODS: The study was carried out in three phases: first, the English version of the MDS-UPDRS was translated into Arabic and subsequently back-translated into English by independent translation team; second, cognitive pretesting of selected items was performed; third, the Arabic version was tested in over 400 native Arabic-speaking PD patients. The psychometric properties of the translated version were analyzed using confirmatory factor analysis (CFA) as well as exploratory factor analysis (EFA). RESULTS: The factor structure of the Arabic version was consistent with that of the English version based on the high CFIs for all four parts of the MDS-UPDRS in the CFA (CFI ≥0.90), confirming its suitability for use in Arabic. CONCLUSIONS: The Arabic version of the MDS-UPDRS has good construct validity in Arabic-speaking patients with PD and has been thereby designated as an official MDS-UPDRS version. The data collection methodology among Arabic-speaking countries across two continents of Asia and Africa provides a roadmap for validating additional MDS rating scale initiatives and is strong evidence that underserved regions can be energically mobilized to promote efforts that apply to better clinical care, education, and research for PD. © 2022 International Parkinson and Movement Disorder Society.

Sleep-related breathing disorders in cerebrovascular stroke and transient ischemic attacks: a comparative study.

Sleep-related breathing disorders are said to be common in patients with established cerebrovascular accidents. The aim of this study was to assess the frequency and characteristics of sleep-related breathing disorders in ischemic stroke and transient ischemic attacks. All patients were subjected to neurologic assessment, Berlin questionnaire (Arabic version), brain computed tomographic scan, and polysomnography along 6 to 8 hours overnight with special emphasis to apnea/hypopnea indices. All assessments were done for 30 patients who had stroke and transient ischemic attacks as well as 20 age- and sex-matched controls. Overall, 13.3% of patients had mild sleep apnea (apnea/hypopnea index, >5), 13.3% had moderate sleep apnea (apnea/hypopnea index, >15), and 34% had severe sleep apnea (apnea/hypopnea index, >30). The sensitivity and specificity of Berlin questionnaire for obstructive sleep apnea diagnosis were 55% and 100%, respectively, for mild sleep apnea, 56.3% and 85.7% for moderate sleep apnea, 66.7% and 83.3% for severe condition. Berlin questionnaire is a moderate sensitive but highly specific screening test for sleep apnea in cerebrovascular diseases. Those who scored high risk should consider polysomnography to specify the type and severity of apnea.