Department of Neurology, University Hospital, Umeå, Sweden.
Mov Disord. 2010 Feb 15;25(3):341-8. doi: 10.1002/mds.22987.
The differential diagnosis of parkinsonian disorders is difficult, especially early in the course of the diseases. The clinical subtypes of Parkinson's disease (PD) have not so far been described in newly diagnosed patients. We present a prospective incidence cohort study of patients with idiopathic parkinsonian syndromes in the Umeå region in northern Sweden identified over a 4-year period. The clinical diagnoses were re-evaluated at follow-up visits at 12 months. We found 138 patients with parkinsonism: 112 PD, 12 multiple system atrophy with predominant parkinsonism (MSA-P), six progressive supranuclear palsy (PSP) and eight unclassifiable patients. The crude incidences for all age ranges per 100,000 were: PD 19.7 (95% confidence interval 16.1-23.3); MSA-P 2.1 (1.1-3.7); PSP 1.1 (0.4-2.4); idiopathic parkinsonism 24.3 (20.2-28.4). Age-standardized to the average Swedish population 2004-2007: PD 22.5 (18.3-26.7); MSA-P 2.4 (1.2-4.2); PSP 1.2 (0.4-2.6); idiopathic parkinsonism 27.5 (22.9-32.1). The crude annual incidence rate for PD, with exclusion of patients with normal dopamine receptor uptake (FP-CIT-SPECT), was 18.8 per 100,000 (95% confidence interval 15.2-22.4), age-adjusted to the average Swedish population 2004 to 2007: 21.5 (17.4-25.6). The incidence rates did not differ significantly between men and women. The cumulative incidence of PD up to 89 years of age was for men 3.4%, for women 2.6%, and for both sexes combined 2.9%. The annual incidence rates found for PD, idiopathic parkinsonism, MSA-P and PSP are among the highest reported.
帕金森病障碍的鉴别诊断具有一定难度，特别是在疾病早期。目前尚未在新发患者中对帕金森病（PD）的临床亚型进行描述。我们进行了一项前瞻性发病队列研究，对瑞典北部于默奥地区在 4 年内确诊的特发性帕金森综合征患者进行了研究。在 12 个月的随访时对临床诊断进行了重新评估。我们共发现 138 例帕金森病患者：112 例 PD、12 例多系统萎缩伴主要帕金森病（MSA-P）、6 例进行性核上性麻痹（PSP）和 8 例无法分类的患者。各年龄段的发病率如下：所有人群中 PD 为 19.7（95%置信区间 16.1-23.3）；MSA-P 为 2.1（1.1-3.7）；PSP 为 1.1（0.4-2.4）；特发性帕金森病为 24.3（20.2-28.4）。根据 2004-2007 年瑞典人口平均年龄进行校正后，PD 为 22.5（18.3-26.7）；MSA-P 为 2.4（1.2-4.2）；PSP 为 1.2（0.4-2.6）；特发性帕金森病为 27.5（22.9-32.1）。不排除多巴胺受体摄取正常的患者（FP-CIT-SPECT）后，PD 的年粗发病率为 18.8/10 万（95%置信区间 15.2-22.4），根据 2004 年至 2007 年瑞典人口平均年龄校正后为 21.5（17.4-25.6）。男性和女性之间的发病率差异无统计学意义。截至 89 岁时，男性 PD 的累积发病率为 3.4%，女性为 2.6%，男女合并为 2.9%。PD、特发性帕金森病、MSA-P 和 PSP 的年发病率均处于报告的最高水平之列。
