Wu Yu-Hsuan, Liao Yi-Chu, Chen Yi-Huei, Chang Ming-Hong, Lin Ching-Heng
Section of Neurology, Taichung Veterans General Hospital, Taichung, Taiwan.
Section of Neurology, Taichung Veterans General Hospital, Taichung, Taiwan; Department of Neurology, National Yang-Ming University School of Medicine, Taipei, Taiwan.
PLoS One. 2015 Jun 24;10(6):e0130282. doi: 10.1371/journal.pone.0130282. eCollection 2015.
To evaluate the risk of premotor symptoms, namely rapid eye movement behavior disorder (RBD), constipation, and depression among patients with newly diagnosed Parkinson disease (PD).
A total of 705 PD patients and 2,820 control subjects were selected from the Taiwan National Health Insurance Research Database. Patients were traced back for a maximum of 14 years to determine the diagnoses of RBD, depression, and constipation. Logistic regression analysis was used to identify risk of premotor symptoms for PD. Moreover, subgroup analyses were performed by dividing the patients into a middle-age onset group (≤ 64 years) and an old-age onset group (≥ 65 years). The associations between these premotor symptoms and age of PD onset were further examined.
An association was found between a history of premotor symptoms and newly diagnosed PD in which a high occurrence of premotor symptoms was identified in PD patients as compared to selected controls (4.3% vs. 1.2% for RBD, 40.4% vs. 24.0% for constipation, and 13.0% vs. 5.1% for depression). The strength of this association remained statistically significant after adjustment for potential confounders (3.69 fold risk for RBD, 2.36 for constipation, and 2.82 for depression, all p < 0.0001). The average interval between premotor symptoms and PD ranged from 4.5 to 6.2 years. RBD and depression carried higher risks for PD in the middle-age onset group than in the old-age onset group (7.20- vs. 2.24-fold risk for RBD, 6.06 vs. 1.40 for depression).
The prevalence of premotor symptoms was higher among the PD patients than in the controls. Premotor symptoms appeared to be associated with a higher risk for PD in subjects with an earlier age of onset.
评估新诊断帕金森病（PD）患者出现运动前症状的风险，即快速眼动睡眠行为障碍（RBD）、便秘和抑郁。
从台湾国民健康保险研究数据库中选取705例PD患者和2820例对照者。对患者进行最长14年的随访，以确定RBD、抑郁和便秘的诊断。采用逻辑回归分析确定PD患者出现运动前症状的风险。此外，将患者分为中年发病组（≤64岁）和老年发病组（≥65岁）进行亚组分析。进一步研究这些运动前症状与PD发病年龄之间的关联。
发现运动前症状史与新诊断的PD之间存在关联，与选定的对照组相比，PD患者中运动前症状的发生率较高（RBD分别为4.3%对1.2%，便秘分别为40.4%对24.0%，抑郁分别为13.0%对5.1%）。在对潜在混杂因素进行调整后，这种关联的强度仍具有统计学意义（RBD的风险为3.69倍，便秘为2.36倍，抑郁为2.82倍，所有p<0.0001）。运动前症状与PD之间的平均间隔为4.5至6.2年。中年发病组中，RBD和抑郁发生PD的风险高于老年发病组（RBD的风险为7.20倍对2.24倍，抑郁为6.06倍对1.40倍）。
PD患者中运动前症状的患病率高于对照组。运动前症状似乎与发病年龄较早的患者发生PD的风险较高有关。
