Wilson R S, Bennett D A, Gilley D W, Beckett L A, Schneider J A, Evans D A
Department of Neurological Sciences, Rush University, Rush-Presbyterian-St. Luke's Medical Center, Chicago, IL, USA.
Neurology. 2000 Mar 28;54(6):1284-9. doi: 10.1212/wnl.54.6.1284.
To describe the progression of parkinsonian signs in persons with AD.
Parkinsonian signs are common in AD and appear to be related to morbidity and mortality. However, little is known about individual patterns of progression of parkinsonian signs.
A cohort of 410 people with clinically diagnosed AD underwent annual clinical evaluations over a 4-year period, with over 90% of survivors participating in follow-up. The entire motor portion of the Unified Parkinson's Disease Rating Scale (UPDRS) was administered at each evaluation. Previously established measures of four parkinsonian signs were derived from the UPDRS. Scores ranged from 0 to 100 and represented the percent obtained of the total possible item score.
A growth curve approach was used to estimate individual paths of change. Rates of change in bradykinesia (4.5% increase per year), rigidity (6.0% increase per year), and gait disorder/postural reflex impairment (8.9% increase per year) were substantial and positively correlated (median r = 0.69). Change in tremor was minimal, mostly confined to postural tremor, and weakly correlated with change in other signs (median r = 0.16). The rate of progression in each sign was highly variable across individuals and not strongly related to demographic factors or use of neuroleptic medications.
Parkinsonian signs other than tremor progress rapidly in AD but at widely differing rates.
描述阿尔茨海默病（AD）患者帕金森氏症体征的进展情况。
帕金森氏症体征在AD中很常见，且似乎与发病率和死亡率相关。然而，关于帕金森氏症体征的个体进展模式知之甚少。
一个由410名临床诊断为AD的患者组成的队列在4年期间接受了年度临床评估，超过90%的幸存者参与了随访。每次评估时均使用统一帕金森病评定量表（UPDRS）的整个运动部分。从UPDRS中得出了先前确定的四种帕金森氏症体征的测量方法。分数范围为0至100，代表获得的总可能项目分数的百分比。
采用生长曲线方法来估计个体变化路径。运动迟缓（每年增加4.5%）、僵硬（每年增加6.0%）和步态障碍/姿势反射受损（每年增加8.9%）的变化率很大且呈正相关（中位数r = 0.69）。震颤变化最小，主要局限于姿势性震颤，且与其他体征变化的相关性较弱（中位数r = 0.16）。每个体征的进展速度在个体间差异很大，且与人口统计学因素或使用抗精神病药物的关系不强。
除震颤外，AD患者的帕金森氏症体征进展迅速，但速度差异很大。
