Brun Lucile, Lefaucheur Romain, Fetter Damien, Derrey Stéphane, Borden Alaina, Wallon David, Bourre Bertrand, Maltête David
Department of Neurology, Rouen University Hospital and University of Rouen, Rouen, France.
Department of Neurosurgery, Rouen University Hospital and University of Rouen, Rouen, France.
Clin Neurol Neurosurg. 2014 Dec;127:93-6. doi: 10.1016/j.clineuro.2014.10.006. Epub 2014 Oct 16.
To describe demographic and clinical characteristics in a group of Parkinson's disease (PD) patients with non-motor fluctuations (NMF) and to evaluate the management of medications proposed to treat NMF.
Three hundred and three PD patients (mean age, 66 ± 10.3 years; mean disease duration, 10.1 ± 6.5 years) were enrolled. Each patient was interviewed in a non-directed fashion about the main NMF manifestations, i.e. dysautonomic, mental, and sensory symptoms. Both groups of patients with and without NMF were compared. Dysautonomia, motor fluctuations, age, disease duration, and LEDD were included in a multiple regression to determine which were predictive of NMF.
NMF were found in 57 (19%) patients, mean age 65 ± 10.1 years, mean age at onset of PD 53.7 ± 10.9 years, mean disease duration 12.5 ± 6.9 years. NMF occurred on average 9.8 ± 7.7 years after the onset of PD. Fifty patients (86%) with NMF had also MF and 10 (21%) had PDD. Twenty-five (44%) patients suffered from sensory, 28 (49%) from autonomic and 25 (44%) from neuropsychiatric symptoms. Both disease and L-Dopa treatment durations, and LEDD were significantly higher in NMF patient's group. Motor fluctuations (p = 0.0016) and presence of dysautonomia (p = 0.007) were found to be two independent predictors of NMF.
The development of new instruments to assess NMF is crucial for optimized management of advanced PD.
描述一组伴有非运动波动（NMF）的帕金森病（PD）患者的人口统计学和临床特征，并评估用于治疗NMF的药物管理情况。
纳入303例PD患者（平均年龄66±10.3岁；平均病程10.1±6.5年）。以非定向方式对每位患者进行访谈，了解主要的NMF表现，即自主神经功能障碍、精神和感觉症状。对有和没有NMF的两组患者进行比较。将自主神经功能障碍、运动波动、年龄、病程和左旋多巴等效剂量（LEDD）纳入多元回归分析，以确定哪些因素可预测NMF。
57例（19%）患者存在NMF，平均年龄65±10.1岁，PD发病的平均年龄53.7±10.9岁，平均病程12.5±6.9年。NMF平均在PD发病后9.8±7.7年出现。50例（86%）有NMF的患者也有运动波动（MF），10例（21%）有帕金森病痴呆（PDD）。25例（44%）患者有感觉症状，28例（49%）有自主神经症状，25例（44%）有神经精神症状。NMF患者组的病程、左旋多巴治疗时间和LEDD均显著更高。发现运动波动（p = 0.0016）和自主神经功能障碍的存在（p = 0.007）是NMF的两个独立预测因素。
开发评估NMF的新工具对于晚期PD的优化管理至关重要。
