Gasparoli E, Delibori D, Polesello G, Santelli L, Ermani M, Battistin L, Bracco F
Department of Neurological and Psychiatric Sciences, University of Padua, Padua, Italy.
Neurol Sci. 2002 Sep;23 Suppl 2:S77-8. doi: 10.1007/s100720200078.
Parkinson's disease is characterized by heterogeneity of clinical presentations, association of signs and symptoms, rate of progression, and response to therapy. The aim of this prospective 5-year study was to evaluate whether clinical features at onset were predictive of the subsequent progression. Two courses were identified which differed in the characteristics at onset. Slow course was characterized by earlier age at onset, lateralization of motor signs, rest tremor, and absence of gait disturbance. Rapid course presented older age, less evident lateralization of signs, predominance of bradykinesia-rigidity and gait disturbance. Our results confirmed that PD is clinically heterogeneous and specific patterns of onset seem to be associated with different rates of disease progression. Predictive models based on these clinical characteristics have a good sensitivity in indicating a slow disease progression but are not reliable in indicating a rapid evolution.
帕金森病的特点是临床表现具有异质性，体征和症状相互关联，疾病进展速度不同，对治疗的反应也各异。这项为期5年的前瞻性研究旨在评估起病时的临床特征是否能预测随后的疾病进展。研究确定了两种起病特征不同的病程。缓慢病程的特点是起病年龄较早、运动体征呈单侧性、静止性震颤以及无步态障碍。快速病程则表现为起病年龄较大、体征的单侧性不明显、以运动迟缓 - 强直为主以及步态障碍。我们的研究结果证实，帕金森病在临床上具有异质性，特定的起病模式似乎与不同的疾病进展速度相关。基于这些临床特征的预测模型在提示疾病进展缓慢方面具有良好的敏感性，但在提示疾病快速进展方面并不可靠。
