轻度帕金森氏征的原因——哪些症状组合可能提示神经退行性变？
Reasons for mild parkinsonian signs - which constellation may indicate neurodegeneration?
作者信息
Lerche Stefanie, Brockmann Kathrin, Wurster Isabel, Gaenslen Alexandra, Roeben Benjamin, Holz Daniel, Eschweiler Gerhard W, Maetzler Walter, Berg Daniela
机构信息
Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tuebingen, Hoppe Seyler-Strasse 3, 72076 Tuebingen, Germany; German Center for Neurodegenerative Diseases, University of Tuebingen, Otfried-Müller-Str. 27, 72076 Tuebingen, Germany.
Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tuebingen, Hoppe Seyler-Strasse 3, 72076 Tuebingen, Germany; German Center for Neurodegenerative Diseases, University of Tuebingen, Otfried-Müller-Str. 27, 72076 Tuebingen, Germany.
出版信息
Parkinsonism Relat Disord. 2015 Feb;21(2):126-30. doi: 10.1016/j.parkreldis.2014.11.018. Epub 2014 Nov 28.
INTRODUCTION
Mild parkinsonian signs (MPS) are common in the elderly population. Several factors including physical decline and comorbidities in addition to neurodegeneration may be possible sources for MPS. The objective was to examine whether MPS are associated with a history of orthopedic disturbances, vascular diseases or prodromal markers for neurodegeneration.
METHODS
The TREND study is a prospective longitudinal cohort study in individuals >50 years with biennial assessments designed to identify prodromal markers for neurodegeneration. In this substudy, 1091 elderly individuals were evaluated for a possible association of MPS with prodromal markers for neurodegeneration, orthopedic disturbances, vascular diseases, as well as cerebral abnormalities. These factors were assessed by self-administered questionnaires, with a structured health interview, a neurological examination and by transcranial sonography.
RESULTS
82 participants showed MPS. They were found to have more often hyposmia and RBD, had a higher autonomic dysfunction score and they more frequently showed hyperechogenicity of the substantia nigra compared to controls. Neither orthopedic disturbances nor vascular diseases were significantly associated with the prevalence of MPS.
CONCLUSION
MPS might be a sign of early neurodegeneration rather than caused by other motor influencing diseases.
引言
轻度帕金森氏征（MPS）在老年人群中很常见。除神经退行性变外，包括身体机能衰退和合并症在内的多种因素可能是MPS的潜在病因。目的是研究MPS是否与骨科疾病史、血管疾病或神经退行性变的前驱标志物有关。
方法
TREND研究是一项针对50岁以上个体的前瞻性纵向队列研究，每两年进行一次评估，旨在识别神经退行性变的前驱标志物。在这项子研究中，对1091名老年人进行了评估，以确定MPS与神经退行性变的前驱标志物、骨科疾病、血管疾病以及脑部异常之间可能存在的关联。这些因素通过自我填写问卷、结构化健康访谈、神经学检查和经颅超声检查进行评估。
结果
82名参与者表现出MPS。与对照组相比，他们更常出现嗅觉减退和快速眼球运动睡眠行为障碍（RBD），自主神经功能障碍评分更高，黑质高回声的情况也更频繁。骨科疾病和血管疾病均与MPS的患病率无显著关联。
结论
MPS可能是早期神经退行性变的一个迹象，而非由其他影响运动的疾病所致。
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