MDS-UPDRS Part IV – Motor Complications

Motor complications, dyskinesias and fluctuations, in Parkinson’s disease. Total 0 to 24.

Completed with clinician input; approximately 5 to 10 minutes.
6 items covering dyskinesia time, dyskinesia disability, OFF time, functional impact of fluctuations, complexity of motor fluctuations, and painful OFF-state dystonias.
Total 0 to 24 (0 = no motor complications).

What it measures

Part IV rates the burden of treatment-related motor complications in people with Parkinson’s disease on dopaminergic therapy. It covers dyskinesias (time spent with dyskinesia, disability from dyskinesia), motor fluctuations (OFF time, complexity, functional impact), and painful OFF-state dystonias. It reflects complications that emerge with long-term levodopa use.

What the result tells you

Higher Part IV scores indicate greater burden from motor complications. Part IV is relevant in people who have been on levodopa long-term and have developed wearing-off or peak-dose dyskinesias. It is used in trials of advanced therapies (continuous dopaminergic infusion, DBS) where motor complication reduction is a key endpoint.

Used for

Evidence, psychometrics and provenance

Psychometrics

Internal consistencyCronbach α = 0.79

Reliability on a 0 to 1 scale. Higher is better.

References

1.Goetz CG, et al. Movement Disorder Society-sponsored revision of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS): scale presentation and clinimetric testing results. Mov Disord. 2008;23(15):2129-2170.