Department of Neurology, University Medical Center Groningen, University of Groningen, The Netherlands.
Mov Disord. 2012 Feb;27(2):206-10. doi: 10.1002/mds.24007. Epub 2011 Oct 12.
Parkinson's disease (PD) characteristically presents with asymmetrical symptoms, contralateral to the side of the most extensive cerebral affection. This intriguing asymmetry, even included in the definition for diagnosing PD, however, is still part of a mystery. The relation with handedness as a common indicator of cerebral asymmetry might provide a clue in the search for causal factors of asymmetrical symptom onset in PD. This possible relationship, however, is still under debate. The objective of this study was to establish whether a relation between handedness and dominant PD side exists. We searched for cross-sectional or cohort studies that registered handedness and onset side in PD patients in PubMed, EMBASE, and Web of Science from their first record until 14 February 2011. Data about handedness and dominant PD side was extracted. Authors who registered both but not described their relation were contacted for further information. Odds ratios (ORs) were analyzed with a fixed effect Mantel-Haenszel model. Heterogeneity and indications of publication bias were limited. Our electronic search identified 10 studies involving 4405 asymmetric PD patients. Of the right-handed patients, 2413 (59.5%) had right-dominant and 1644 (40.5%) had left-dominant PD symptoms. For the left-handed patients this relation was reversed, with 142 (40.8%) right-dominant and 206 (59.2%) left-dominant PD symptoms. Overall OR was 2.13 (95% confidence interval [CI], 1.71-2.66). Handedness and symptom dominance in PD are firmly related with each other in such a way that the PD symptoms emerge more often on the dominant hand-side. Possible causal factors are discussed.
帕金森病（PD）的特征是出现不对称症状，与大脑受影响最广泛的对侧相反。这种有趣的不对称性，甚至包括在 PD 的诊断定义中，但仍然是一个谜。与作为大脑不对称性常见指标的利手的关系可能为寻找 PD 不对称症状发作的因果因素提供线索。然而，这种可能的关系仍存在争议。本研究的目的是确定利手与 PD 优势侧之间是否存在关系。我们在 PubMed、EMBASE 和 Web of Science 中搜索了从首次记录到 2011 年 2 月 14 日为止登记 PD 患者利手和发病侧的横断面或队列研究。提取了利手和 PD 优势侧的数据。对于登记了但未描述其关系的作者，我们联系以获取更多信息。采用固定效应 Mantel-Haenszel 模型分析比值比（OR）。限制了异质性和发表偏倚的指示。我们的电子搜索确定了 10 项涉及 4405 例不对称 PD 患者的研究。在右利手患者中，2413 例（59.5%）为右优势，1644 例（40.5%）为左优势 PD 症状。对于左利手患者，这种关系相反，142 例（40.8%）为右优势，206 例（59.2%）为左优势 PD 症状。总体 OR 为 2.13（95%置信区间 [CI]，1.71-2.66）。PD 中的利手和症状优势彼此密切相关，PD 症状更常出现在优势手侧。讨论了可能的因果因素。
