Measurement Properties of Clinical Scales Rating the Severity of Blepharospasm: A Multicenter Observational Study

Giovanni Defazio, Mark Hallett, Alfredo Berardelli, Joel S. Perlmutter, Brian D. Berman, Joseph Jankovic, Tobias Bäumer, Cynthia Comella, Tommaso Ercoli, Gina Ferrazzano, Susan H. Fox, Han Joon Kim, Emile Sami Moukheiber, Sarah Pirio Richardson, Anne Weissbach, Angelo F. Gigante, Hyder A. Jinnah

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Several scales have been proposed to clinically evaluate the Motor Severity of Blepharospasm (BSP) but information about their measurement properties as a multicenter instrument is limited. Objective: To compare the measurement properties of four clinical scales in rating the severity of BSP in a large sample of patients from multiple sites. Methods: The Burke–Fahn–Marsden Scale (BFMS), the Global Dystonia Severity Rating Scale (GDRS), the Jankovic Rating Scale (JRS), and the Blepharospasm Severity Rating Scale (BSRS) were administered to 211 patients across 10 sites who were also requested to self-complete the Blepharospasm Disability Index (BDI). Measurement properties to be assessed included inter−/intra-observer agreement, item-to-total correlation, internal consistency, floor and ceiling effect, convergent/discriminant validity, and adherence to the distribution of BDI. Results: The BFMS had unsatisfactory measurement properties, the GDRS had acceptable reliability but other properties could not be completely testable; the JRS had satisfactory measurement properties but the scale did not accurately reflect the distribution of disability parameter (BDI) in the sample, and the BSRS had satisfactory measurement properties and also showed the best adherence to the distribution of BDI in the assessed sample. Conclusion: The comparison of the measurement properties of four rating scales to assess the motor state of the BSP in a large sample of patients from multiple sites showed that the GDRS should be used to simultaneously assess BSP and dystonia in other body parts, while the JRS (easier to use) and BSRS (better to discriminate severity) should be used to assess BSP alone.

Original languageEnglish
Pages (from-to)949-955
Number of pages7
JournalMovement Disorders Clinical Practice
Volume9
Issue number7
DOIs
StatePublished - Oct 2022

Keywords

  • Blepharospasm
  • dystonia
  • measurement properties
  • rating scale
  • severity of illness index

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