Garcia-Ruiz P J, Feliz-Feliz C E, Maycas-Cepeda T, Del Val-Fernandez J
Fundacion Jimenez Diaz, 28040 Madrid, Espana.
Hospital Quiron Madrid, Madrid, Espana.
Rev Neurol. 2018 Jan 16;66(2):45-48.
Reduced facial expression or amimia is one of the most typical characteristics of Parkinson's disease (PD). Despite being described in classic texts, its significance, physiopathology and correlation with motor and non-motor symptoms is largely unknown.
We have studied facial bradykinesia in a group of 84 de novo PD patients prospectively evaluated for five years. We also studied the relationship of facial bradykinesia with depression in a subgroup of 30 patients.
Baseline and follow-up assessments were performed with the Unified Parkinson's Disease Rating Scale (UPDRS). Baseline facial bradykinesia was rated according to item 19 of UPDRS. Baseline facial bradykinesia correlated with total and motor baseline UPDRS. In addition, baseline bradykinesia correlated with total and motor UPDRS at five years. However baseline bradykinesia did not influence the presence of motor (motor fluctuation, dyskinesias and freezing of gait) or non-motor complications (delusion, behavior abnormalities and dementia) at five years. Finally a subgroup of 30 patients completed the self-report version of the Quick Inventory of Depressive Symptoms (QIDS-SR16) questionnaire, facial bradykinesia did not correlate with QIDS-SR16 scores.
Our study suggests that baseline facial bradykinesia correlates with general baseline situation in PD and even might predict the motor and functional status at five years.
面部表情减少或表情缺失是帕金森病(PD)最典型的特征之一。尽管在经典文献中有描述,但其意义、病理生理学以及与运动和非运动症状的相关性在很大程度上尚不清楚。
我们前瞻性地研究了一组84例初发PD患者的面部运动迟缓,为期五年。我们还在30例患者的亚组中研究了面部运动迟缓与抑郁的关系。
采用统一帕金森病评定量表(UPDRS)进行基线和随访评估。根据UPDRS第19项对面部运动迟缓进行基线评分。基线面部运动迟缓与UPDRS总分及运动基线评分相关。此外,基线运动迟缓与五年时的UPDRS总分及运动评分相关。然而,基线运动迟缓在五年时并未影响运动(运动波动、异动症和步态冻结)或非运动并发症(妄想、行为异常和痴呆)的出现。最后,30例患者的亚组完成了抑郁症状快速自评量表(QIDS-SR16)问卷,面部运动迟缓与QIDS-SR16评分不相关。
我们的研究表明,基线面部运动迟缓与PD的总体基线情况相关,甚至可能预测五年时的运动和功能状态。