<> <http://www.w3.org/2000/01/rdf-schema#comment> "The repository administrator has not yet configured an RDF license."^^<http://www.w3.org/2001/XMLSchema#string> .
<> <http://xmlns.com/foaf/0.1/primaryTopic> <https://discovery.ucl.ac.uk/id/eprint/10205922> .
<https://discovery.ucl.ac.uk/id/eprint/10205922> <http://www.w3.org/1999/02/22-rdf-syntax-ns#type> <http://purl.org/ontology/bibo/AcademicArticle> .
<https://discovery.ucl.ac.uk/id/eprint/10205922> <http://www.w3.org/1999/02/22-rdf-syntax-ns#type> <http://purl.org/ontology/bibo/Article> .
<https://discovery.ucl.ac.uk/id/eprint/10205922> <http://purl.org/dc/terms/title> "Variability of the Penn upper motor neuron score in amyotrophic lateral sclerosis: need for a revised score"^^<http://www.w3.org/2001/XMLSchema#string> .
<https://discovery.ucl.ac.uk/id/eprint/10205922> <http://purl.org/ontology/bibo/abstract> "There is a need for a consensus on a clinical scale for evaluating upper motor neuron (UMN) burden in amyotrophic lateral sclerosis (ALS) to improve consistency in clinical diagnosis, research and monitoring of disease progression. The Penn upper motor neuron score (PUMNS) is the most commonly published scale, however, the reliability of the scale has only been evaluated in a single study involving two raters. The objective of this study was to evaluate the inter-rater reliability of the PUMNS in ALS patients among multiple raters, and to discuss an updated UMN score including the signs with the highest inter-rater reliability. This study included seven ALS patients (mean age: 71 ± 11.5, six males, one female). Each patient was evaluated with the PUMNS by eight raters from different centers blinded to previous observations. The intra-class correlation coefficient (ICC) was calculated to assess the inter-rater reliability of the total PUMNS. The inter-rater reliability of the binary subscores was assessed with Gwet's AC1 coefficient. The inter-rater agreement for the total PUMNS yielded an ICC of 0.81 (95% CI 0.56;0.96). Items with the highest inter-rater reliability included Hoffman's sign, Babinski's sign, clonus and deep tendon reflexes, while the facial reflex (Gwet's AC1 -0.038 (95% CI -0.25,0.18)) and crossed adduction (0.18 (95% CI (-0.32,0.67)) had the lowest inter-rater reliability. In conclusion, PUMNS demonstrated good inter-rater reliability overall, while some of the subscores had poor inter-rater reliability. Based on this, we call for an updated UMN score to enhance diagnostic accuracy and research consistency in ALS."^^<http://www.w3.org/2001/XMLSchema#string> .
<https://discovery.ucl.ac.uk/id/eprint/10205922> <http://purl.org/dc/terms/date> "2025" .
<https://discovery.ucl.ac.uk/id/document/1837940> <http://www.w3.org/1999/02/22-rdf-syntax-ns#type> <http://purl.org/ontology/bibo/Document> .
<https://discovery.ucl.ac.uk/id/eprint/10205922> <http://purl.org/ontology/bibo/volume> "272" .
<https://discovery.ucl.ac.uk/id/eprint/10205922> <http://purl.org/ontology/bibo/issue> "3" .
<https://discovery.ucl.ac.uk/id/org/ext-9fda52d9214c90d0b9b27e191441f372> <http://www.w3.org/1999/02/22-rdf-syntax-ns#type> <http://xmlns.com/foaf/0.1/Organization> .
<https://discovery.ucl.ac.uk/id/org/ext-9fda52d9214c90d0b9b27e191441f372> <http://xmlns.com/foaf/0.1/name> "SPRINGER HEIDELBERG"^^<http://www.w3.org/2001/XMLSchema#string> .
<https://discovery.ucl.ac.uk/id/eprint/10205922> <http://purl.org/dc/terms/publisher> <https://discovery.ucl.ac.uk/id/org/ext-9fda52d9214c90d0b9b27e191441f372> .
<https://discovery.ucl.ac.uk/id/publication/ext-536354af2c8c839735c320c44995ca1d> <http://www.w3.org/1999/02/22-rdf-syntax-ns#type> <http://purl.org/ontology/bibo/Collection> .
<https://discovery.ucl.ac.uk/id/publication/ext-536354af2c8c839735c320c44995ca1d> <http://xmlns.com/foaf/0.1/name> "Journal of Neurology"^^<http://www.w3.org/2001/XMLSchema#string> .
<https://discovery.ucl.ac.uk/id/eprint/10205922> <http://purl.org/dc/terms/isPartOf> <https://discovery.ucl.ac.uk/id/publication/ext-536354af2c8c839735c320c44995ca1d> .
<https://discovery.ucl.ac.uk/id/eprint/10205922> <http://purl.org/ontology/bibo/status> <http://purl.org/ontology/bibo/status/published> .
<https://discovery.ucl.ac.uk/id/eprint/10205922> <http://purl.org/dc/terms/creator> <https://discovery.ucl.ac.uk/id/person/ext-675eb5b4b07a5c90904c23c35def9678> .
<https://discovery.ucl.ac.uk/id/eprint/10205922> <http://purl.org/ontology/bibo/authorList> <https://discovery.ucl.ac.uk/id/eprint/10205922#authors> .
<https://discovery.ucl.ac.uk/id/eprint/10205922#authors> <http://www.w3.org/1999/02/22-rdf-syntax-ns#_1> <https://discovery.ucl.ac.uk/id/person/ext-675eb5b4b07a5c90904c23c35def9678> .
<https://discovery.ucl.ac.uk/id/eprint/10205922> <http://purl.org/dc/terms/creator> <https://discovery.ucl.ac.uk/id/person/ext-1da3392eec8b8034ba73ce22885d9258> .
<https://discovery.ucl.ac.uk/id/eprint/10205922> <http://purl.org/ontology/bibo/authorList> <https://discovery.ucl.ac.uk/id/eprint/10205922#authors> .
<https://discovery.ucl.ac.uk/id/eprint/10205922#authors> <http://www.w3.org/1999/02/22-rdf-syntax-ns#_2> <https://discovery.ucl.ac.uk/id/person/ext-1da3392eec8b8034ba73ce22885d9258> .
<https://discovery.ucl.ac.uk/id/eprint/10205922> <http://purl.org/dc/terms/creator> <https://discovery.ucl.ac.uk/id/person/ext-9122b7cde8809a5ca58a672a03c2bdc7> .
<https://discovery.ucl.ac.uk/id/eprint/10205922> <http://purl.org/ontology/bibo/authorList> <https://discovery.ucl.ac.uk/id/eprint/10205922#authors> .
<https://discovery.ucl.ac.uk/id/eprint/10205922#authors> <http://www.w3.org/1999/02/22-rdf-syntax-ns#_3> <https://discovery.ucl.ac.uk/id/person/ext-9122b7cde8809a5ca58a672a03c2bdc7> .
<https://discovery.ucl.ac.uk/id/eprint/10205922> <http://purl.org/dc/terms/creator> <https://discovery.ucl.ac.uk/id/person/ext-8df86bdf9332a52c09ab10086196a621> .
<https://discovery.ucl.ac.uk/id/eprint/10205922> <http://purl.org/ontology/bibo/authorList> <https://discovery.ucl.ac.uk/id/eprint/10205922#authors> .
<https://discovery.ucl.ac.uk/id/eprint/10205922#authors> <http://www.w3.org/1999/02/22-rdf-syntax-ns#_4> <https://discovery.ucl.ac.uk/id/person/ext-8df86bdf9332a52c09ab10086196a621> .
<https://discovery.ucl.ac.uk/id/eprint/10205922> <http://purl.org/dc/terms/creator> <https://discovery.ucl.ac.uk/id/person/ext-0d438ed4441c278abe8eab8d23072f20> .
<https://discovery.ucl.ac.uk/id/eprint/10205922> <http://purl.org/ontology/bibo/authorList> <https://discovery.ucl.ac.uk/id/eprint/10205922#authors> .
<https://discovery.ucl.ac.uk/id/eprint/10205922#authors> <http://www.w3.org/1999/02/22-rdf-syntax-ns#_5> <https://discovery.ucl.ac.uk/id/person/ext-0d438ed4441c278abe8eab8d23072f20> .
<https://discovery.ucl.ac.uk/id/eprint/10205922> <http://purl.org/dc/terms/creator> <https://discovery.ucl.ac.uk/id/person/ext-863d6592f54c227e14c59384311eb432> .
<https://discovery.ucl.ac.uk/id/eprint/10205922> <http://purl.org/ontology/bibo/authorList> <https://discovery.ucl.ac.uk/id/eprint/10205922#authors> .
<https://discovery.ucl.ac.uk/id/eprint/10205922#authors> <http://www.w3.org/1999/02/22-rdf-syntax-ns#_6> <https://discovery.ucl.ac.uk/id/person/ext-863d6592f54c227e14c59384311eb432> .
<https://discovery.ucl.ac.uk/id/eprint/10205922> <http://purl.org/dc/terms/creator> <https://discovery.ucl.ac.uk/id/person/ext-60273dabf3926d72426fd32e62c2d9a7> .
<https://discovery.ucl.ac.uk/id/eprint/10205922> <http://purl.org/ontology/bibo/authorList> <https://discovery.ucl.ac.uk/id/eprint/10205922#authors> .
<https://discovery.ucl.ac.uk/id/eprint/10205922#authors> <http://www.w3.org/1999/02/22-rdf-syntax-ns#_7> <https://discovery.ucl.ac.uk/id/person/ext-60273dabf3926d72426fd32e62c2d9a7> .
<https://discovery.ucl.ac.uk/id/eprint/10205922> <http://purl.org/dc/terms/creator> <https://discovery.ucl.ac.uk/id/person/ext-728264bdb1adff443cf17884cb4958f6> .
<https://discovery.ucl.ac.uk/id/eprint/10205922> <http://purl.org/ontology/bibo/authorList> <https://discovery.ucl.ac.uk/id/eprint/10205922#authors> .
<https://discovery.ucl.ac.uk/id/eprint/10205922#authors> <http://www.w3.org/1999/02/22-rdf-syntax-ns#_8> <https://discovery.ucl.ac.uk/id/person/ext-728264bdb1adff443cf17884cb4958f6> .
<https://discovery.ucl.ac.uk/id/eprint/10205922> <http://purl.org/dc/terms/creator> <https://discovery.ucl.ac.uk/id/person/ext-a73a9514398ec29ce19f024eb8041499> .
<https://discovery.ucl.ac.uk/id/eprint/10205922> <http://purl.org/ontology/bibo/authorList> <https://discovery.ucl.ac.uk/id/eprint/10205922#authors> .
<https://discovery.ucl.ac.uk/id/eprint/10205922#authors> <http://www.w3.org/1999/02/22-rdf-syntax-ns#_9> <https://discovery.ucl.ac.uk/id/person/ext-a73a9514398ec29ce19f024eb8041499> .
<https://discovery.ucl.ac.uk/id/eprint/10205922> <http://purl.org/dc/terms/creator> <https://discovery.ucl.ac.uk/id/person/ext-2a48ba80fff5dd77a3b2740738ea05ba> .
<https://discovery.ucl.ac.uk/id/eprint/10205922> <http://purl.org/ontology/bibo/authorList> <https://discovery.ucl.ac.uk/id/eprint/10205922#authors> .
<https://discovery.ucl.ac.uk/id/eprint/10205922#authors> <http://www.w3.org/1999/02/22-rdf-syntax-ns#_10> <https://discovery.ucl.ac.uk/id/person/ext-2a48ba80fff5dd77a3b2740738ea05ba> .
<https://discovery.ucl.ac.uk/id/eprint/10205922> <http://purl.org/dc/terms/creator> <https://discovery.ucl.ac.uk/id/person/ext-42d45c1732137e0bf7ed697aa21f3026> .
<https://discovery.ucl.ac.uk/id/eprint/10205922> <http://purl.org/ontology/bibo/authorList> <https://discovery.ucl.ac.uk/id/eprint/10205922#authors> .
<https://discovery.ucl.ac.uk/id/eprint/10205922#authors> <http://www.w3.org/1999/02/22-rdf-syntax-ns#_11> <https://discovery.ucl.ac.uk/id/person/ext-42d45c1732137e0bf7ed697aa21f3026> .
<https://discovery.ucl.ac.uk/id/eprint/10205922> <http://purl.org/dc/terms/creator> <https://discovery.ucl.ac.uk/id/person/ext-3c692b1856aad9bc0ddf7c186e582870> .
<https://discovery.ucl.ac.uk/id/eprint/10205922> <http://purl.org/ontology/bibo/authorList> <https://discovery.ucl.ac.uk/id/eprint/10205922#authors> .
<https://discovery.ucl.ac.uk/id/eprint/10205922#authors> <http://www.w3.org/1999/02/22-rdf-syntax-ns#_12> <https://discovery.ucl.ac.uk/id/person/ext-3c692b1856aad9bc0ddf7c186e582870> .
<https://discovery.ucl.ac.uk/id/eprint/10205922> <http://purl.org/dc/terms/creator> <https://discovery.ucl.ac.uk/id/person/ext-0b669028e780fceb46661adf14b22265> .
<https://discovery.ucl.ac.uk/id/eprint/10205922> <http://purl.org/ontology/bibo/authorList> <https://discovery.ucl.ac.uk/id/eprint/10205922#authors> .
<https://discovery.ucl.ac.uk/id/eprint/10205922#authors> <http://www.w3.org/1999/02/22-rdf-syntax-ns#_13> <https://discovery.ucl.ac.uk/id/person/ext-0b669028e780fceb46661adf14b22265> .
<https://discovery.ucl.ac.uk/id/person/ext-9122b7cde8809a5ca58a672a03c2bdc7> <http://www.w3.org/1999/02/22-rdf-syntax-ns#type> <http://xmlns.com/foaf/0.1/Person> .
<https://discovery.ucl.ac.uk/id/person/ext-9122b7cde8809a5ca58a672a03c2bdc7> <http://xmlns.com/foaf/0.1/givenName> "Mamede"^^<http://www.w3.org/2001/XMLSchema#string> .
<https://discovery.ucl.ac.uk/id/person/ext-9122b7cde8809a5ca58a672a03c2bdc7> <http://xmlns.com/foaf/0.1/familyName> "de Carvalho"^^<http://www.w3.org/2001/XMLSchema#string> .
<https://discovery.ucl.ac.uk/id/person/ext-9122b7cde8809a5ca58a672a03c2bdc7> <http://xmlns.com/foaf/0.1/name> "Mamede de Carvalho"^^<http://www.w3.org/2001/XMLSchema#string> .
<https://discovery.ucl.ac.uk/id/person/ext-2a48ba80fff5dd77a3b2740738ea05ba> <http://www.w3.org/1999/02/22-rdf-syntax-ns#type> <http://xmlns.com/foaf/0.1/Person> .
<https://discovery.ucl.ac.uk/id/person/ext-2a48ba80fff5dd77a3b2740738ea05ba> <http://xmlns.com/foaf/0.1/givenName> "Wilfred"^^<http://www.w3.org/2001/XMLSchema#string> .
<https://discovery.ucl.ac.uk/id/person/ext-2a48ba80fff5dd77a3b2740738ea05ba> <http://xmlns.com/foaf/0.1/familyName> "Nix"^^<http://www.w3.org/2001/XMLSchema#string> .
<https://discovery.ucl.ac.uk/id/person/ext-2a48ba80fff5dd77a3b2740738ea05ba> <http://xmlns.com/foaf/0.1/name> "Wilfred Nix"^^<http://www.w3.org/2001/XMLSchema#string> .
<https://discovery.ucl.ac.uk/id/person/ext-60273dabf3926d72426fd32e62c2d9a7> <http://www.w3.org/1999/02/22-rdf-syntax-ns#type> <http://xmlns.com/foaf/0.1/Person> .
<https://discovery.ucl.ac.uk/id/person/ext-60273dabf3926d72426fd32e62c2d9a7> <http://xmlns.com/foaf/0.1/givenName> "Jakob"^^<http://www.w3.org/2001/XMLSchema#string> .
<https://discovery.ucl.ac.uk/id/person/ext-60273dabf3926d72426fd32e62c2d9a7> <http://xmlns.com/foaf/0.1/familyName> "Blicher"^^<http://www.w3.org/2001/XMLSchema#string> .
<https://discovery.ucl.ac.uk/id/person/ext-60273dabf3926d72426fd32e62c2d9a7> <http://xmlns.com/foaf/0.1/name> "Jakob Blicher"^^<http://www.w3.org/2001/XMLSchema#string> .
<https://discovery.ucl.ac.uk/id/person/ext-0b669028e780fceb46661adf14b22265> <http://www.w3.org/1999/02/22-rdf-syntax-ns#type> <http://xmlns.com/foaf/0.1/Person> .
<https://discovery.ucl.ac.uk/id/person/ext-0b669028e780fceb46661adf14b22265> <http://xmlns.com/foaf/0.1/givenName> "Hatice"^^<http://www.w3.org/2001/XMLSchema#string> .
<https://discovery.ucl.ac.uk/id/person/ext-0b669028e780fceb46661adf14b22265> <http://xmlns.com/foaf/0.1/familyName> "Tankisi"^^<http://www.w3.org/2001/XMLSchema#string> .
<https://discovery.ucl.ac.uk/id/person/ext-0b669028e780fceb46661adf14b22265> <http://xmlns.com/foaf/0.1/name> "Hatice Tankisi"^^<http://www.w3.org/2001/XMLSchema#string> .
<https://discovery.ucl.ac.uk/id/person/ext-8df86bdf9332a52c09ab10086196a621> <http://www.w3.org/1999/02/22-rdf-syntax-ns#type> <http://xmlns.com/foaf/0.1/Person> .
<https://discovery.ucl.ac.uk/id/person/ext-8df86bdf9332a52c09ab10086196a621> <http://xmlns.com/foaf/0.1/givenName> "Martin"^^<http://www.w3.org/2001/XMLSchema#string> .
<https://discovery.ucl.ac.uk/id/person/ext-8df86bdf9332a52c09ab10086196a621> <http://xmlns.com/foaf/0.1/familyName> "Koltzenburg"^^<http://www.w3.org/2001/XMLSchema#string> .
<https://discovery.ucl.ac.uk/id/person/ext-8df86bdf9332a52c09ab10086196a621> <http://xmlns.com/foaf/0.1/name> "Martin Koltzenburg"^^<http://www.w3.org/2001/XMLSchema#string> .
<https://discovery.ucl.ac.uk/id/person/ext-42d45c1732137e0bf7ed697aa21f3026> <http://www.w3.org/1999/02/22-rdf-syntax-ns#type> <http://xmlns.com/foaf/0.1/Person> .
<https://discovery.ucl.ac.uk/id/person/ext-42d45c1732137e0bf7ed697aa21f3026> <http://xmlns.com/foaf/0.1/givenName> "Jean-Philippe"^^<http://www.w3.org/2001/XMLSchema#string> .
<https://discovery.ucl.ac.uk/id/person/ext-42d45c1732137e0bf7ed697aa21f3026> <http://xmlns.com/foaf/0.1/familyName> "Camdessanche"^^<http://www.w3.org/2001/XMLSchema#string> .
<https://discovery.ucl.ac.uk/id/person/ext-42d45c1732137e0bf7ed697aa21f3026> <http://xmlns.com/foaf/0.1/name> "Jean-Philippe Camdessanche"^^<http://www.w3.org/2001/XMLSchema#string> .
<https://discovery.ucl.ac.uk/id/person/ext-a73a9514398ec29ce19f024eb8041499> <http://www.w3.org/1999/02/22-rdf-syntax-ns#type> <http://xmlns.com/foaf/0.1/Person> .
<https://discovery.ucl.ac.uk/id/person/ext-a73a9514398ec29ce19f024eb8041499> <http://xmlns.com/foaf/0.1/givenName> "Mia B"^^<http://www.w3.org/2001/XMLSchema#string> .
<https://discovery.ucl.ac.uk/id/person/ext-a73a9514398ec29ce19f024eb8041499> <http://xmlns.com/foaf/0.1/familyName> "Heintzelmann"^^<http://www.w3.org/2001/XMLSchema#string> .
<https://discovery.ucl.ac.uk/id/person/ext-a73a9514398ec29ce19f024eb8041499> <http://xmlns.com/foaf/0.1/name> "Mia B Heintzelmann"^^<http://www.w3.org/2001/XMLSchema#string> .
<https://discovery.ucl.ac.uk/id/person/ext-863d6592f54c227e14c59384311eb432> <http://www.w3.org/1999/02/22-rdf-syntax-ns#type> <http://xmlns.com/foaf/0.1/Person> .
<https://discovery.ucl.ac.uk/id/person/ext-863d6592f54c227e14c59384311eb432> <http://xmlns.com/foaf/0.1/givenName> "Bulent"^^<http://www.w3.org/2001/XMLSchema#string> .
<https://discovery.ucl.ac.uk/id/person/ext-863d6592f54c227e14c59384311eb432> <http://xmlns.com/foaf/0.1/familyName> "Cengiz"^^<http://www.w3.org/2001/XMLSchema#string> .
<https://discovery.ucl.ac.uk/id/person/ext-863d6592f54c227e14c59384311eb432> <http://xmlns.com/foaf/0.1/name> "Bulent Cengiz"^^<http://www.w3.org/2001/XMLSchema#string> .
<https://discovery.ucl.ac.uk/id/person/ext-1da3392eec8b8034ba73ce22885d9258> <http://www.w3.org/1999/02/22-rdf-syntax-ns#type> <http://xmlns.com/foaf/0.1/Person> .
<https://discovery.ucl.ac.uk/id/person/ext-1da3392eec8b8034ba73ce22885d9258> <http://xmlns.com/foaf/0.1/givenName> "Gaia"^^<http://www.w3.org/2001/XMLSchema#string> .
<https://discovery.ucl.ac.uk/id/person/ext-1da3392eec8b8034ba73ce22885d9258> <http://xmlns.com/foaf/0.1/familyName> "Fanella"^^<http://www.w3.org/2001/XMLSchema#string> .
<https://discovery.ucl.ac.uk/id/person/ext-1da3392eec8b8034ba73ce22885d9258> <http://xmlns.com/foaf/0.1/name> "Gaia Fanella"^^<http://www.w3.org/2001/XMLSchema#string> .
<https://discovery.ucl.ac.uk/id/person/ext-3c692b1856aad9bc0ddf7c186e582870> <http://www.w3.org/1999/02/22-rdf-syntax-ns#type> <http://xmlns.com/foaf/0.1/Person> .
<https://discovery.ucl.ac.uk/id/person/ext-3c692b1856aad9bc0ddf7c186e582870> <http://xmlns.com/foaf/0.1/givenName> "Anders"^^<http://www.w3.org/2001/XMLSchema#string> .
<https://discovery.ucl.ac.uk/id/person/ext-3c692b1856aad9bc0ddf7c186e582870> <http://xmlns.com/foaf/0.1/familyName> "Fuglsang-Frederiksen"^^<http://www.w3.org/2001/XMLSchema#string> .
<https://discovery.ucl.ac.uk/id/person/ext-3c692b1856aad9bc0ddf7c186e582870> <http://xmlns.com/foaf/0.1/name> "Anders Fuglsang-Frederiksen"^^<http://www.w3.org/2001/XMLSchema#string> .
<https://discovery.ucl.ac.uk/id/person/ext-728264bdb1adff443cf17884cb4958f6> <http://www.w3.org/1999/02/22-rdf-syntax-ns#type> <http://xmlns.com/foaf/0.1/Person> .
<https://discovery.ucl.ac.uk/id/person/ext-728264bdb1adff443cf17884cb4958f6> <http://xmlns.com/foaf/0.1/givenName> "Izabella"^^<http://www.w3.org/2001/XMLSchema#string> .
<https://discovery.ucl.ac.uk/id/person/ext-728264bdb1adff443cf17884cb4958f6> <http://xmlns.com/foaf/0.1/familyName> "Obal"^^<http://www.w3.org/2001/XMLSchema#string> .
<https://discovery.ucl.ac.uk/id/person/ext-728264bdb1adff443cf17884cb4958f6> <http://xmlns.com/foaf/0.1/name> "Izabella Obal"^^<http://www.w3.org/2001/XMLSchema#string> .
<https://discovery.ucl.ac.uk/id/person/ext-0d438ed4441c278abe8eab8d23072f20> <http://www.w3.org/1999/02/22-rdf-syntax-ns#type> <http://xmlns.com/foaf/0.1/Person> .
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