Tomic Svetlana, Rajkovaca Ines, Pekic Vlasta, Salha Tamer, Misevic Sanja
Clinical Department of Neurology, Osijek University Hospital Center, J. Huttlera 4, 31000, Osijek, Croatia.
School of Medicine, Josip Juraj Strossmayer University, J. Huttlera 4, Osijek, Croatia.
Acta Neurol Belg. 2017 Mar;117(1):207-211. doi: 10.1007/s13760-016-0739-6. Epub 2016 Dec 27.
Autonomic dysfunctions are part of a spectrum of non-motor symptoms in Parkinson's disease (PD) patients. The aim of the study was to assess the prevalence of autonomic dysfunctions and their influence on the quality of life (QoL) in PD patients, adjusted for age, sex, disease duration and motor symptoms. Patients were evaluated for motor function (Unified Parkinson's Disease Rating Scale, UPDRS part III), disease stage (Hoehn and Yahr scale, H&Y scale), autonomic dysfunction (Scales for Outcomes in Parkinson's disease, Autonomic, SCOPA-AUT) and QoL (Parkinson's Disease Questionnaire-39, PDQ-39). Urinary, gastrointestinal and sexual autonomic dysfunctions were most frequently reported, while the most severe symptoms were reported for sexual and urinary systems. Age and motor symptoms did not correlate with autonomic dysfunction, while disease duration correlated with cardiovascular dysfunction. There were sex differences on the thermoregulation subscale. All types of autonomic dysfunction influenced QoL, mostly gastrointestinal and thermoregulatory dysfunctions, except for sexual one. Many aspects of QoL (activity of daily living, emotion, cognitive functions, communication and social support) except for stigma and mobility were affected by autonomic dysfunctions. Age, disease duration, sex and motor symptoms were not found to affect global QoL scores, but had detrimental effects on different PDQ-39 dimensions. Autonomic dysfunctions influence QoL in more aspects than motor symptoms, age, disease duration and sex. Patients tend to be more stigmatized with motor than non-motor symptoms.
自主神经功能障碍是帕金森病（PD）患者非运动症状谱的一部分。本研究的目的是评估自主神经功能障碍的患病率及其对PD患者生活质量（QoL）的影响，并对年龄、性别、病程和运动症状进行校正。对患者进行运动功能评估（统一帕金森病评定量表第三部分，UPDRS）、疾病分期（霍恩和亚尔分级量表，H&Y量表）、自主神经功能障碍评估（帕金森病自主神经功能结局量表，SCOPA-AUT）和生活质量评估（帕金森病问卷-39，PDQ-39）。最常报告的是泌尿、胃肠和性自主神经功能障碍，而性和泌尿系统报告的症状最为严重。年龄和运动症状与自主神经功能障碍无关，而病程与心血管功能障碍相关。在体温调节子量表上存在性别差异。除性功能障碍外，所有类型的自主神经功能障碍均影响生活质量，主要是胃肠和体温调节功能障碍。除耻辱感和活动能力外，生活质量的许多方面（日常生活活动、情绪、认知功能、沟通和社会支持）均受自主神经功能障碍影响。未发现年龄、病程、性别和运动症状影响总体生活质量评分，但对不同的PDQ-39维度有不利影响。自主神经功能障碍比运动症状、年龄、病程和性别在更多方面影响生活质量。与非运动症状相比，患者因运动症状更容易受到耻辱感。
