Ayala Alba, Triviño-Juárez José Matías, Forjaz Maria João, Rodríguez-Blázquez Carmen, Rojo-Abuin José-Manuel, Martínez-Martín Pablo
Centre for Human and Social Sciences, Spanish Scientific Research Council (CCHS, CSIC) and Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Madrid, Spain.
West Health District, Primary Care Center Francia, Madrid Health Service, Madrid, Spain.
Front Neurol. 2017 Oct 30;8:551. doi: 10.3389/fneur.2017.00551. eCollection 2017.
The aim of this study is to present a predictive model of Parkinson's disease (PD) global severity, measured with the Clinical Impression of Severity Index for Parkinson's Disease (CISI-PD).
This is an observational, longitudinal study with annual follow-up assessments over 3 years (four time points). A multilevel analysis and multiple imputation techniques were performed to generate a predictive model that estimates changes in the CISI-PD at 1, 2, and 3 years.
The clinical state of patients (CISI-PD) significantly worsened in the 3-year follow-up. However, this change was of small magnitude (effect size: 0.44). The following baseline variables were significant predictors of the global severity change: baseline global severity of disease, levodopa equivalent dose, depression and anxiety symptoms, autonomic dysfunction, and cognitive state. The goodness-of-fit of the model was adequate, and the sensitive analysis showed that the data imputation method applied was suitable.
Disease progression depends more on the individual's baseline characteristics than on the 3-year time period. Results may contribute to a better understanding of the evolution of PD including the non-motor manifestations of the disease.
本研究旨在呈现一种帕金森病（PD）整体严重程度的预测模型，该模型通过帕金森病严重程度临床印象指数（CISI-PD）进行衡量。
这是一项观察性纵向研究，进行了为期3年的年度随访评估（四个时间点）。采用多水平分析和多重填补技术生成一个预测模型，以估计1年、2年和3年时CISI-PD的变化。
在3年的随访中，患者的临床状态（CISI-PD）显著恶化。然而，这种变化幅度较小（效应量：0.44）。以下基线变量是整体严重程度变化的显著预测因素：疾病的基线整体严重程度、左旋多巴等效剂量、抑郁和焦虑症状、自主神经功能障碍以及认知状态。模型的拟合优度良好，敏感性分析表明所应用的数据填补方法是合适的。
疾病进展更多地取决于个体基线特征，而非3年的时间段。研究结果可能有助于更好地理解帕金森病的演变，包括该疾病的非运动表现。
