对用于识别非典型帕金森症的十步测试的重新评估。
A reappraisal of the ten steps test for identifying atypical parkinsonism.
作者信息
Morales-Briceño Hugo, Rodríguez-Violante Mayela, Martinez-Ramirez Daniel, Cervantes-Arriaga Amin
机构信息
Department of Neurology, Instituto Nacional de Neurología y Neurocirugía, México, Mexico; Movement Disorders Clinic, Instituto Nacional de Neurología y Neurocirugía, México, Mexico.
Clinical Neurodegenerative Disease Research Unit, Instituto Nacional de Neurología y Neurocirugía, México, Mexico; Movement Disorders Clinic, Instituto Nacional de Neurología y Neurocirugía, México, Mexico.
出版信息
Clin Neurol Neurosurg. 2014 Apr;119:1-3. doi: 10.1016/j.clineuro.2013.12.022. Epub 2014 Jan 10.
INTRODUCTION
Gait abnormalities are prominent in atypical parkinsonian disorders and clinical signs such abnormal tandem walk have been suggested as a red flag for differential diagnosis. The objective is to determine the sensibility and specificity of the ten-steps test to discriminate atypical parkinsonisms from Parkinson's disease.
METHODS
A sample of subjects with a parkinsonian disorder was evaluated. The ten-steps test was applied to all subjects. A Bayesian analysis model was used to calculate sensibility and specificity.
RESULTS
A total of 32 subjects with atypical parkinsonism and 54 subjects with Parkinson's disease were included. Abnormal tandem gait had a sensitivity of 90.6% and specificity of 66.6% to differentiate between groups. When adjusted to the actual atypical parkinsonism prevalence the positive predictive value fall from 61.7% to 13.8%.
CONCLUSION
The ten-steps test provides additional information for the differential diagnosis in parkinsonian disorders but can only be regarded as a red flag.
引言
步态异常在非典型帕金森病中较为突出，诸如异常串联行走等临床体征被认为是鉴别诊断的警示信号。目的是确定十步试验鉴别非典型帕金森综合征与帕金森病的敏感性和特异性。
方法
对一组帕金森病患者样本进行评估。对所有受试者进行十步试验。采用贝叶斯分析模型计算敏感性和特异性。
结果
共纳入32例非典型帕金森病患者和54例帕金森病患者。异常串联步态在区分两组时的敏感性为90.6%，特异性为66.6%。当根据实际非典型帕金森病患病率进行调整时，阳性预测值从61.7%降至13.8%。
结论
十步试验为帕金森病的鉴别诊断提供了额外信息，但只能被视为一个警示信号。
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