Pan Weidong, Ohashi Kyoko, Yamamoto Yoshiharu, Kwak Shin
Department of Neurology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Mov Disord. 2007 Jul 15;22(9):1308-13. doi: 10.1002/mds.21527.
We aimed to obtain a reliable, objective scale representing disease severity for appropriate management of patients with Parkinson's disease (PD). Nineteen patients with PD at the Department of Neurology, Tokyo University Hospital, were classified into mild (n = 10) or severe groups (n = 9) depending on their Hoehn-Yahr scores, and wore accelerometers on their wrists for more than 6 consecutive days. During this time we monitored their subjective assessments of symptom severity and analyzed the power-law exponents (alpha) for local maxima and minima of fluctuations in the activity time series. Statistical comparisons were made between the severe and mild groups and of individual patients on "good condition" and "bad condition" days, as well as between days before and after antiparkinsonism medication. In all patients, the alpha for local maxima was always lower when parkinsonism was mild than when severe. Presence of tremor did not influence the alpha for local maxima. As the lower alpha value for local maxima of fluctuations in activity records reflects more frequent switching behavior from low to high physical activities or the severity of akinesia, actigraph monitoring of parkinsonism, and analysis of its power-law correlation may provide useful objective information for controlling parkinsonism in outpatient clinics and for evaluating new antiparkinsonism drugs.
我们旨在获得一种可靠、客观的量表，以代表帕金森病（PD）患者病情严重程度，从而对其进行适当管理。东京大学医院神经内科的19例帕金森病患者根据其Hoehn-Yahr评分分为轻度组（n = 10）或重度组（n = 9），并在手腕上佩戴加速度计连续超过6天。在此期间，我们监测了他们对症状严重程度的主观评估，并分析了活动时间序列波动的局部最大值和最小值的幂律指数（α）。对重度组和轻度组之间、个体患者“状况良好”和“状况不佳”日之间以及抗帕金森病药物治疗前后的天数进行了统计比较。在所有患者中，帕金森病轻度时活动记录局部最大值的α值始终低于重度时。震颤的存在不影响局部最大值的α值。由于活动记录波动局部最大值的较低α值反映了从低体力活动到高体力活动的更频繁转换行为或运动不能的严重程度，帕金森病的活动记录仪监测及其幂律相关性分析可能为门诊控制帕金森病和评估新的抗帕金森病药物提供有用的客观信息。
