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帕金森病队列研究的全球概述,但并不完整

Global, Yet Incomplete Overview of Cohort Studies in Parkinson's disease.

作者信息

Heinzel Sebastian, Lerche Stefanie, Maetzler Walter, Berg Daniela

机构信息

Department of Neurology, Christian-Albrechts-University, Kiel, Germany.

German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany.

出版信息

J Parkinsons Dis. 2017;7(3):423-432. doi: 10.3233/JPD-171100.

Abstract

BACKGROUND

Parkinson's disease (PD) is characterized by heterogeneity and multifactorial longitudinal changes. To identify PD subtypes and factors influencing the disease course, multiple cohort studies have been designed globally. Knowledge about existing cohorts is pivotal to foster collaboration, which may help to advance the understanding of PD.

OBJECTIVE

To raise the awareness about PD cohorts and potential global collaboration opportunities.

METHODS

Observational cohort studies in clinical PD were identified by a European working group (JPND BioLoC-PD) and through literature search. Using a structured survey investigators of 44 cohorts provided basic information on cohorts and assessments performed.

RESULTS

For the 44 cohorts (32% on early/de-novo PD), 14.666 participants (cohorts' median: 138; range: 23-3.090), a median 1.5-year follow-up interval (0.5-4 years) and a median (planned) observational period of 5 years (1-20 years) were indicated. All studies have assessed motor functions often using rating scales (UPDRS-III; 93% of studies) and less frequently quantitative gait/balance (25%) or fine motor assessments (27%). Cognitive (100%), neuropsychiatric (91%), daily living (78%), sleep (70%), sensory (63%), and gastrointestinal/autonomic (55%) assessments were common and often comparable. Neuroimaging data (82%) and biomaterial (69%) have been collected in many studies. Surprisingly, possible disease modifiers, such as sport/physical activity (11%), have rarely been assessed.

CONCLUSIONS

Existing data of PD cohorts provide vast collaboration opportunities. We propose to establish a comprehensive, up-to-date, open-access internet platform with easy-to-use search tools of PD cohort descriptions and potentially available data. Bringing researchers together to enable collaborative joint, meta- and replication analyses is timely and necessary to advance PD research ultimately required for an understanding of PD that can be translated into more effective therapies.

摘要

背景

帕金森病(PD)具有异质性和多因素纵向变化的特点。为了识别PD亚型和影响疾病进程的因素,全球范围内开展了多项队列研究。了解现有队列对于促进合作至关重要,这可能有助于加深对PD的认识。

目的

提高对PD队列及潜在全球合作机会的认识。

方法

一个欧洲工作组(JPND BioLoC-PD)通过文献检索确定了临床PD的观察性队列研究。44个队列的研究人员通过结构化调查提供了队列的基本信息以及所进行的评估。

结果

对于这44个队列(32%针对早期/新发PD),共有14666名参与者(队列中位数:138;范围:23 - 3090),随访间隔中位数为1.5年(0.5 - 4年),观察期中位数(计划)为5年(1 - 20年)。所有研究都对运动功能进行了评估,常用评分量表(统一帕金森病评定量表第三部分[UPDRS-III];93%的研究),较少使用定量步态/平衡评估(25%)或精细运动评估(27%)。认知(100%)、神经精神(91%)、日常生活(78%)、睡眠(70%)、感觉(63%)以及胃肠道/自主神经(55%)评估较为常见且通常具有可比性。许多研究收集了神经影像学数据(82%)和生物材料(69%)。令人惊讶的是,诸如运动/体育活动等可能的疾病修饰因素很少被评估(11%)。

结论

PD队列的现有数据提供了大量合作机会。我们建议建立一个全面、最新、开放获取的互联网平台,并配备易于使用的搜索工具,用于查找PD队列描述和潜在可用数据。将研究人员聚集在一起,开展协作性的联合、荟萃分析和重复分析,对于推进PD研究是及时且必要的,而PD研究最终是理解PD并转化为更有效治疗方法所必需的。

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