帕金森病患者脑白质异常的临床相关性。
Clinical correlates of cerebral white matter abnormalities in patients with Parkinson's disease.
机构信息
Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Nijmegen, The Netherlands.
Radboud University Medical Center, Department of Radiology and Nuclear Medicine, Nijmegen, The Netherlands.
出版信息
Parkinsonism Relat Disord. 2018 Apr;49:28-33. doi: 10.1016/j.parkreldis.2017.12.029. Epub 2017 Dec 27.
OBJECTIVE
To determine if autonomic dysfunction, cognitive disorders or axial disability are associated with white matter lesions (WML) in Parkinson disease (PD).
METHODS
We performed a retrospective cross-sectional review study on 204 consecutive PD patients who underwent cerebral MRI in our center between January 2012 and July 2016. For each patient, we scored the severity of WML and PV (periventricular) WML using the Fazekas score and using the ARWMC scale for WML and BG (basal ganglia) and clinical characteristics such as neurogenic orthostatic hypotension and cognitive function.
RESULTS
204 PD patients were included of whom n = 53 (26.0%) had neurogenic orthostatic hypotension (nOH). The presence of nOH was significantly associated with the severity of WML as defined by the Fazekas score and the ARWMC scale. An ordinal regression model confirmed this association with an OR of 0.41 (95% CI 0.18-0.92: p = .03) and an OR of 0.39 (95% CI 0.17-0.88: p = .02). There were no significant associations between WML and other co-variables, including hypertension, dopaminergic medication use, Hoehn and Yahr stage, gender and cognitive decline.
CONCLUSION
The presence of nOH is associated with WML severity in PD patients.
目的
确定自主神经功能障碍、认知障碍或轴性残疾是否与帕金森病（PD）患者的脑白质病变（WML）有关。
方法
我们对 2012 年 1 月至 2016 年 7 月在我们中心接受脑部 MRI 的 204 例连续 PD 患者进行了回顾性横断面研究。对于每位患者，我们使用 Fazekas 评分和 ARWMC 量表对 WML 和 PV（脑室周围）WML 的严重程度进行评分，并对神经源性直立性低血压和认知功能等临床特征进行评分。
结果
共纳入 204 例 PD 患者，其中 53 例（26.0%）存在神经源性直立性低血压（nOH）。nOH 的存在与 Fazekas 评分和 ARWMC 量表定义的 WML 严重程度显著相关。有序回归模型证实了这种关联，OR 为 0.41（95%CI 0.18-0.92：p=0.03）和 OR 为 0.39（95%CI 0.17-0.88：p=0.02）。WML 与其他协变量（包括高血压、多巴胺能药物使用、Hoehn 和 Yahr 分期、性别和认知下降）之间无显著相关性。
结论
nOH 的存在与 PD 患者的 WML 严重程度有关。
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