Gökçal Elif, Gür Veysel Eren, Selvitop Rabia, Babacan Yildiz Gülsen, Asil Talip
Department of Neurology, Bezmialem Vakıf University School of Medicine, İstanbul, Turkey.
Noro Psikiyatr Ars. 2017 Jun;54(2):143-148. doi: 10.5152/npa.2016.12758. Epub 2016 Nov 11.
This study aimed to evaluate motor and non-motor symptoms in idiopathic Parkinson's disease (IPD) patients and to determine the self-reported influence of all existing symptoms on their quality of life (QoL).
The sociodemographic and clinical characteristics, medical treatments, and Modified Hoehn and Yahr (mH&Y) scores of IPD patients without cognitive impairment were recorded. A survey questioning different motor and non-motor symptoms was administered to the patients. The patients were asked to rate their symptoms by number from the greatest influence to the least influence on their QoL. Subjects were divided into two groups: those suffering from IPD for ≤5 years (Group 1) and those suffering from IPD for >5 years (Group 2). These groups were compared in terms of sociodemographic and clinical characteristics, existing symptoms, and influences of these symptoms on their QoL.
There were 63 patients in Group 1 and 37 patients in Group 2. No statistically significant differences were detected between the groups with respect to sociodemographic characteristics or mH&Y scores. The most common motor symptoms in both of these groups were tremor and bradykinesia; meanwhile, the non-motor symptoms most frequently encountered in these groups were pain-cramps, constipation, and excessive daytime sleepiness (EDS). Again, while the symptoms that most greatly disturbed QoL in all patients were reported to be tremor and bradykinesia, the most disturbing non-motor symptom was frequent voiding/incontinence, which was a less common symptom. Pain-cramp, constipation, and EDS, which were the most frequent non-motor symptoms, were the symptoms that least disturbed QoL.
It is widely accepted that motor symptoms determine QoL in IPD. However, non-motor symptoms are seen during all phases of the disease. The impact of non-motor symptoms on the QoL of IPD patients remains substantial. Therefore, in addition to the well-known motor symptoms, non-motor symptoms, which may be overlooked during physical examination yet may profoundly impact QoL, should be questioned and treated appropriately to improve QoL in PD patients as much as possible.
本研究旨在评估特发性帕金森病(IPD)患者的运动和非运动症状,并确定所有现有症状对其生活质量(QoL)的自我报告影响。
记录无认知障碍的IPD患者的社会人口统计学和临床特征、医学治疗情况以及改良Hoehn和Yahr(mH&Y)评分。对患者进行了一项询问不同运动和非运动症状的调查。要求患者根据症状对其生活质量影响程度从大到小进行编号评分。受试者分为两组:患IPD≤5年的患者(第1组)和患IPD>5年的患者(第2组)。比较了两组在社会人口统计学和临床特征、现有症状以及这些症状对其生活质量的影响方面的差异。
第1组有63例患者,第2组有37例患者。两组在社会人口统计学特征或mH&Y评分方面未检测到统计学上的显著差异。这两组中最常见的运动症状是震颤和运动迟缓;同时,这些组中最常遇到的非运动症状是疼痛性痉挛、便秘和日间过度嗜睡(EDS)。同样,虽然据报告所有患者中对生活质量干扰最大的症状是震颤和运动迟缓,但最令人困扰的非运动症状是频繁排尿/尿失禁,这是一种不太常见的症状。疼痛性痉挛、便秘和EDS是最常见的非运动症状,也是对生活质量干扰最小的症状。
人们普遍认为运动症状决定了IPD患者的生活质量。然而,在疾病的所有阶段都可出现非运动症状。非运动症状对IPD患者生活质量的影响仍然很大。因此,除了众所周知的运动症状外,在体格检查中可能被忽视但可能对生活质量产生深远影响的非运动症状,应进行询问并给予适当治疗,以尽可能改善PD患者的生活质量。