Derejko Mirosława, Sławek Jarosław, Wieczorek Dariusz, Dubaniewicz Mirosława, Lass Piotr
Zakład Neurofizjologii Klinicznej, Instytut Psychiatrii i Neurologii, ul. Sobieskiego 9, 02-957 Warszawa.
Neurol Neurochir Pol. 2006 Jul-Aug;40(4):276-83.
The aim of the study was to assess the prevalence of vascular risk factors and white matter hyperintensities (WMH) in patients with Parkinson's disease (PD) and its impact on clinical features such as motor impairment.
60 patients with PD [25 women and 35 men; mean age 68.4 (51-81) years, mean duration of disease 8.4 (1-27) years] with good response to L-Dopa were studied. Besides neurological examination, the degree of motor impairment was evaluated in all patients using UPDRS, Hoehn-Yahr, and Schwab-England scales. All patients underwent MRI to assess the degree of WMH using Age Related White Matter Changes (ARWMC) Wahlund scale. Moreover, the prevalence of classic vascular risk factors included arterial hypertension, diabetes mellitus t. 1 and 2; plasma cholesterol, cardiovascular diseases, alcohol abuse and smoking was assessed.
Presence of at least one vascular risk factor was noted in 19 patients (31.7%). No significant differences were found between the groups of patients with and without vascular risk factors with regard to all clinical parameters and total ARWMC score. These factors did not differ between the groups of patients with more than 3 vascular risk factors and other patients. WMH (ARWMC > or =1) occurred in 33 patients (55%). No significant differences in all analysed clinical factors and the total number of vascular risk factors between the groups with (ARWMC > or =1) and without (ARWMC=0) WMH were found. The group of patients with at least one focus with score of 2 in the Wahlund scale did not differ significantly in all analysed clinical parameters from the rest of the patients.
Our data suggest that the severity of WMH and incidence of vascular risk factors are not significantly related with the degree of motor disability in PD.
本研究旨在评估帕金森病（PD）患者血管危险因素和脑白质高信号（WMH）的患病率及其对运动障碍等临床特征的影响。
对60例对左旋多巴反应良好的PD患者[25例女性和35例男性；平均年龄68.4（51 - 81）岁，平均病程8.4（1 - 27）年]进行研究。除神经系统检查外，所有患者均使用统一帕金森病评定量表（UPDRS）、霍恩 - 亚尔分级（Hoehn - Yahr）和施瓦布 - 英格兰量表（Schwab - England）评估运动障碍程度。所有患者均接受磁共振成像（MRI）检查，使用年龄相关脑白质改变（ARWMC）瓦伦德量表评估WMH程度。此外，评估经典血管危险因素的患病率，包括动脉高血压、1型和2型糖尿病、血浆胆固醇、心血管疾病、酗酒和吸烟。
19例患者（31.7%）存在至少一种血管危险因素。在所有临床参数和总ARWMC评分方面，有血管危险因素和无血管危险因素的患者组之间未发现显著差异。有超过3种血管危险因素的患者组与其他患者组之间这些因素也无差异。33例患者（55%）出现WMH（ARWMC≥1）。在有（ARWMC≥1）和无（ARWMC = 0）WMH的患者组之间，所有分析的临床因素和血管危险因素总数均未发现显著差异。在瓦伦德量表中至少有一个评分为2的病灶的患者组在所有分析的临床参数方面与其他患者组无显著差异。
我们的数据表明，WMH的严重程度和血管危险因素的发生率与PD患者的运动残疾程度无显著相关性。
