Nakano I, Fujimoto K
Department of Neurology, Jichi Medical School.
Nihon Rinsho. 2000 Oct;58(10):2132-8.
Parkinson's disease is a progressive neurodegenerative disorder. Motor functions of patients with Parkinson's disease are determined by its cardinal symptoms: akinesia, tremor, rigidity and disturbed righting reflexes. To evaluate degree of disability and rate of its progression in Parkinson disease, simple but reliable and reproducible rating scales are essential. Those that essentially fulfil such conditions are Hoehn and Yahr Scale, Schwab and England Scale, and Unified Parkinson's Disease Rating Scale (UPDRS). Levodopa, the major anti-parkinsonian agent, has greatly improved the motor functions of the Parkinson's disease patients and prolonged their life expectancy. Studies using the above mentioned scales compared the rate of disability progression and the motor functional prognosis between pre- and post-levodopa era, and always demonstrated the levodopa's benefits for the prognosis. Side effects of long administration of levodopa such as motor fluctuation, dyskinesia, wearing-off or on-off phenomenon, and psychosis, however, are disability factors to the patients' motor functions. Rating scales that can integrate the side effects to evaluate the functions will be required.
帕金森病是一种进行性神经退行性疾病。帕金森病患者的运动功能由其主要症状决定：运动不能、震颤、僵硬和翻正反射障碍。为了评估帕金森病的残疾程度及其进展速度，简单但可靠且可重复的评定量表至关重要。基本满足这些条件的量表有霍恩和雅尔量表、施瓦布和英格兰量表以及统一帕金森病评定量表（UPDRS）。左旋多巴是主要的抗帕金森病药物，它极大地改善了帕金森病患者的运动功能并延长了他们的预期寿命。使用上述量表的研究比较了左旋多巴治疗前后的残疾进展速度和运动功能预后，始终证明了左旋多巴对预后的益处。然而，长期服用左旋多巴的副作用，如运动波动、异动症、疗效减退或开关现象以及精神病，都是影响患者运动功能的残疾因素。需要能够综合这些副作用来评估功能的评定量表。
