患有快速眼动睡眠行为障碍的早期帕金森病患者认知功能的纵向变化。
Longitudinal changes in cognition in early Parkinson's disease patients with REM sleep behavior disorder.
作者信息
Chahine L M, Xie S X, Simuni T, Tran B, Postuma R, Amara A, Oertel W H, Iranzo A, Scordia C, Fullard M, Linder C, Purri R, Darin A, Rennert L, Videnovic A, Del Riva P, Weintraub D
机构信息
The University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
The University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
出版信息
Parkinsonism Relat Disord. 2016 Jun;27:102-6. doi: 10.1016/j.parkreldis.2016.03.006. Epub 2016 Mar 12.
INTRODUCTION
Cognitive decline is common in Parkinson's disease (PD), and identifying patients at highest risk for it is essential. We aimed to examine the effect of possible REM sleep behavior disorder (pRBD) on rate of cognitive decline in early PD, for both global cognition and in specific cognitive domains.
METHODS
Parkinson's Progression Markers Initiative (PPMI) is a multi-site, international study of PD patients untreated at enrollment. pRBD was assessed with the REM sleep behavior disorder questionnaire (RBDSQ). Global cognition was assessed at baseline and annually using the Montreal Cognitive Assessment (MoCA) and a cognitive battery. Linear mixed effects models were used to examine the relationship between pRBD (RBDSQ≥6) and rate of change in cognitive variables. Age, sex, years of education, and baseline motor and cognitive scores were included as covariates.
RESULTS
The baseline sample consisted of 423 individuals with PD, mean age 61.7 years and 65.5% male. Data was available on 389, 366, and 196 participants at 1-year, 2-year, and 3-year follow-up respectively. Possible RBD occurred in 108 (25.5%) at baseline. In multivariate analyses, baseline RBD was associated with greater annual rate of decline in MoCA score (β = -0.34, 95%CI -0.54, -0.13, p < 0.001), Symbol Digit Modalities Test (β = -0.69, 95%CI -1.3, -0.09, p = 0.024), and Hopkins Verbal Learning Test-Revised, delayed free recall (β = -0.21, 95%CI -0.41, -0.013, p = 0.037).
CONCLUSIONS
Possible RBD is common in early PD and predicts future cognitive decline, particularly in attention and memory domains.
引言
认知功能衰退在帕金森病（PD）中很常见，识别出风险最高的患者至关重要。我们旨在研究可能的快速眼动睡眠行为障碍（pRBD）对早期PD患者认知功能衰退速度的影响，包括整体认知和特定认知领域。
方法
帕金森病进展标志物倡议（PPMI）是一项针对入组时未接受治疗的PD患者的多中心国际研究。使用快速眼动睡眠行为障碍问卷（RBDSQ）评估pRBD。在基线和每年使用蒙特利尔认知评估（MoCA）和一套认知测试组合评估整体认知。使用线性混合效应模型研究pRBD（RBDSQ≥6）与认知变量变化率之间的关系。将年龄、性别、受教育年限以及基线运动和认知分数作为协变量纳入分析。
结果
基线样本包括423名PD患者，平均年龄61.7岁，男性占65.5%。在1年、2年和3年随访时分别有389名、366名和196名参与者有可用数据。基线时108名（25.5%）患者存在可能的RBD。在多变量分析中，基线RBD与MoCA评分（β = -0.34，95%CI -0.54，-0.13，p < 0.001）、符号数字模式测试（β = -0.69，95%CI -1.3，-0.09，p = 0.024）以及霍普金斯词语学习测试修订版的延迟自由回忆（β = -0.21，95%CI -0.41，-0.013，p = 0.037）的年衰退率更高相关。
结论
可能的RBD在早期PD中很常见，并可预测未来的认知衰退，尤其是在注意力和记忆领域。
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