Gigante Angelo Fabio, Pellicciari Roberta, Iliceto Giovanni, Liuzzi Daniele, Mancino Paola Vincenza, Custodero Giacomo Emanuele, Guido Marco, Livrea Paolo, Defazio Giovanni
Department of Basic Medical Sciences, Neurosciences and Sensory Organs, "Aldo Moro" University of Bari, Italy.
Department of Basic Medical Sciences, Neurosciences and Sensory Organs, "Aldo Moro" University of Bari, Italy; Department of Neurology and Psychiatry, Sapienza University of Rome, Italy.
J Neurol Sci. 2017 Apr 15;375:215-219. doi: 10.1016/j.jns.2016.12.057. Epub 2016 Dec 28.
To assess body distribution and timing of appearance of rest tremor in Parkinson's disease.
Information was obtained by a computerized database containing historical information collected at the first visit and data collected during the subsequent follow-up visits. Information on rest tremor developed during the follow-up could be therefore obtained by our own observation in a proportion of patients.
Among 289 patients, rest tremor was reported at disease onset in 65.4% of cases and detected at last follow-up examination in 74.4% of patients. Analysis of patients who did not report rest tremor at disease onset indicated that 26% of such patients (9% in the overall population) manifested rest tremor over the disease course. Rest tremor spread to new sites in 39% of patients who manifested rest tremor at disease onset. Regardless of tremor presentation at disease onset or during the follow-up, upper limb was the most frequent tremor localization. Over the follow-up, rest tremor developed faster in the upper limb than in other body sites. The risk of developing rest tremor during the follow-up was not affected by sex, side of motor symptom onset and site of tremor presentation. However, age of disease onset >63years was associated with an increased risk of rest tremor spread.
This study provides new information about body distribution and timing of rest tremor appearance during the course of early stages of Parkinson's disease that may help clinicians in patients' counselling.
评估帕金森病静止性震颤的身体分布及出现时间。
通过一个计算机化数据库获取信息，该数据库包含首次就诊时收集的历史信息以及后续随访就诊时收集的数据。因此，在部分患者中，我们可通过自身观察获取随访期间出现的静止性震颤信息。
在289例患者中，65.4%的病例在疾病发作时报告有静止性震颤，74.4%的患者在最后一次随访检查时检测到静止性震颤。对疾病发作时未报告静止性震颤的患者进行分析表明，此类患者中有26%（占总体人群的9%）在疾病过程中出现了静止性震颤。在疾病发作时出现静止性震颤的患者中，39%的患者静止性震颤扩散到了新部位。无论在疾病发作时还是随访期间出现震颤，上肢都是最常见的震颤部位。在随访过程中，上肢静止性震颤的发展速度比身体其他部位更快。随访期间出现静止性震颤的风险不受性别、运动症状发作侧和震颤出现部位的影响。然而，发病年龄>63岁与静止性震颤扩散风险增加有关。
本研究提供了关于帕金森病早期阶段静止性震颤出现的身体分布和时间的新信息，这可能有助于临床医生为患者提供咨询。
