Operative Unit of Neurology, "Dimiccoli" General Hospital, Barletta, Italy.
Operative Unit of Nuclear Medicine, "Dimiccoli" General Hospital, Barletta, Italy.
Parkinsonism Relat Disord. 2014 Jan;20(1):17-21. doi: 10.1016/j.parkreldis.2013.09.004. Epub 2013 Sep 12.
Non-motor symptoms (NMS) in Parkinson's disease (PD) are common, increase the patients' disability and have a significantly negative impact on their quality of life. Essential tremor (ET) is also affected by non-motor symptoms and often enters into the differential diagnosis with PD. Brain scintigraphy with [(123)I]β-CIT SPECT is a technique used to facilitate differential diagnosis between PD and ET.
We evaluated both motor impairment (MDS-UPDRS-III) and non-motor symptoms (NMSQuest) in patients who underwent a [(123)I]β-CIT SPECT examination for diagnostic purposes. Both the clinical and the scintigraphic data obtained from the selected PD (n = 31) and ET (n = 22) patients were compared.
We did not detect a significant difference in the total number of NMS reported by either PD (10.4 ± 4.9) or ET patients (8.41 ± 3.3). PD patients reported more drooling (29%), hyposmia (32.2%), hallucinations (19.3%), difficulty in concentrating (51.6%), orthostatic dizziness (67.7%), falling (19.3%), vivid dreams (32.2%), REM sleep behavior disorder (58%), and diplopia (22.5%) compared with ET patients. PD patients who complained of drooling, orthostatic dizziness, and diplopia had greater denervation of the caudata than did the PD patients who did not report the same symptoms. The differences observed were not associated with differences in age, sex, UPDRS-III score, and the presence/absence of tremor.
The declaration of non-motor symptoms is influenced by subjective factors that are widely suggestible. When analyzed early and before receiving a definitive diagnosis, PD patients complain of specific symptoms that seem to depend on different pathogenetic mechanisms.
帕金森病（PD）的非运动症状（NMS）很常见，会增加患者的残疾程度，并对其生活质量产生显著的负面影响。特发性震颤（ET）也受非运动症状的影响，并且常与 PD 进行鉴别诊断。使用 [(123)I]β-CIT SPECT 脑闪烁显像术是一种用于辅助 PD 和 ET 之间进行鉴别诊断的技术。
我们评估了因诊断目的而接受 [(123)I]β-CIT SPECT 检查的患者的运动障碍（MDS-UPDRS-III）和非运动症状（NMSQuest）。比较了从选定的 PD（n = 31）和 ET（n = 22）患者中获得的临床和闪烁显像数据。
我们未发现 PD（10.4 ± 4.9）或 ET 患者（8.41 ± 3.3）报告的 NMS 总数有显著差异。与 ET 患者相比，PD 患者报告更多流涎（29%）、嗅觉减退（32.2%）、幻觉（19.3%）、注意力难以集中（51.6%）、直立性头晕（67.7%）、跌倒（19.3%）、生动的梦（32.2%）、REM 睡眠行为障碍（58%）和复视（22.5%）。报告流涎、直立性头晕和复视的 PD 患者的尾状核去神经支配程度大于未报告相同症状的 PD 患者。观察到的差异与年龄、性别、UPDRS-III 评分以及震颤的存在/不存在无关。
非运动症状的申报受到广泛暗示的主观因素的影响。在早期且在获得明确诊断之前进行分析时，PD 患者会抱怨一些特定的症状，这些症状似乎取决于不同的发病机制。
