Clinical Outcome Assessments in Movement Disorders: A Scoping Review of Current Rating Scales and Future Needs Beyond Parkinson's Disease
Year: 2026
Type: review
Abstract: BACKGROUND: Clinical outcome assessments (COA) are essential for evaluating symptom severity, treatment response, and disease progression in movement disorders. As clinical knowledge evolves, it is necessary to ensure COAs continued relevance and validity. OBJECTIVES: The aims were to provide an updated overview of existing Movement Disorder Society (MDS)-recommended COAs in movement disorders and to identify specific constructs or COAs requiring further revision or validation to inform current clinical practice and research. METHODS: The Scientific Evaluation Committee of the MDS-COA program commissioned a position paper on the current evidentiary state of COAs. A panel of experts conducted a 2-step review: first, extracting data from previous MDS publications on COA appraisals using a standardized template; second, conducting a scoping review up to May 2026 to identify new COAs or updated validation data in movement disorders. All study designs were considered. RESULTS: Of the 13 constructs identified in movement disorders other than PD, updated reviews are most urgently warranted for tremor and dystonia, given the volume of new evidence, emergence of novel instruments, and expanding therapeutic options. For all remaining constructs, important advances were identified alongside persistent gaps in validation, longitudinal data, and clinical interpretability. CONCLUSIONS: The principal challenge in movement-disorder outcome assessment has shifted from developing new instruments to establishing their comparative validity, responsiveness, and clinical interpretability. Tremor and dystonia have accumulated sufficient new evidence to justify updated MDS reviews, whereas across all constructs the major unmet needs are harmonization of existing measures, longitudinal validation, and integration of patient-reported and digital outcomes into clinically meaningful assessment frameworks.
DOI: 10.1002/mdc3.70890
Institutions: Karolinska Institutet, Onze Lieve Vrouwziekenhuis Hospital, Karolinska University Hospital, Monash Health, Kingston Centre, University of Calgary, Hotchkiss Brain Institute, UNSW Sydney, St George Hospital, University of Pecs, Muhimbili National Hospital, University of Florida, Thai Red Cross Society, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Office of the Royal Society, University of Cincinnati, University of Ottawa, Ottawa Hospital Research Institute, uOttawa Brain and Mind Research Institute, Biomedical Research Networking Center on Neurodegenerative Diseases, Hospital Universitario 12 De Octubre, Centro de Investigación Biomédica en Red, Rush University Medical Center, University of Pavol Jozef Šafárik, Univerzitná Nemocnica Louisa Pasteura
Language: English
Subfield: Clinical Neurology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,400
OpenAlex ID: W7225454440