Chen Tuanzhi, Fan Yan, Zhuang Xianbo, Feng Depeng, Chen Yanxiu, Chan Piu, Du Yifeng
a Department of Neurology , Liaocheng People's Hospital and Liaocheng Clinical School of Taishan Medical University , Liaocheng , China.
b Key Laboratory on Neurodegenerative Disorders of Ministry of Education, Department of Neurobiology, Beijing Institute of Geriatrics , Xuanwu Hospital, Capital Medical University , Beijing , China.
Neurol Res. 2018 Jun;40(6):491-498. doi: 10.1080/01616412.2018.1451017. Epub 2018 Jun 5.
We investigated postural sway in patients with early Parkinson's disease (PD) to test the hypothesis that the postural control system was affected already at an early stage of PD. Moreover, we identified cases of dysfunction of stereopsis in PD patients.
We examined 23 patients with early PD and 23 healthy, sex- and age-matched control subjects. Postural sway was measured with an accelerometer at the center of mass at the lower spine. Subjects were asked to stand quietly for 30 s under two usual conditions (eyes open and eyes closed) and two dual tasks conditions (eyes open with dual task, eyes closed with dual task). Stereopsis was assessed using the Titmus fly test.
In the usual conditions, no differences were found between the control group and PD group. With increasing task difficulty, PD patients showed an increase of RMS values of sway acceleration, compared to control subjects. These differences reached significance during cognitive task performance. PD patients showed larger JERK values with increasing difficulty of the sway task which also reached significance during cognitive task performance. Relative to controls, PD patients showed decreased stereopsis function. But, there were no statistically significant correlations between log seconds of arc of the Titmus test and JERK, even during cognitive task performance.
Our results indicate that patients with early PD have subtle signs of postural instability when their attention is diverted or reduced. In addition, deficits of stereopsis may be common in early PD patients. St Abbreviations: ACC: Accelerometers; ANOVA: Analysis of variance; AP: Antero-posterior; COP: Center of pressure; EC: Eyes closed; ECDT: eyes closed with dual task; EO: Eyes open; EODT: Eyes open with dual task; GDS: Geriatric depression scale; JERK: Jerkiness of sway; ML: Medio-lateral; MMSE: Mini mental state examination; MoCA: Montreal cognitive assessment; PD: Parkinson's disease; PDAbS: PD Patients with abnormal stereopsis; PDNrS: PD Patients with normal stereopsis; PIGD: Postural instability and gait disorder; RMS: Root mean square; UPDRS: Unified Parkinson's disease rating scale.
我们研究了早期帕金森病（PD）患者的姿势摆动情况，以验证姿势控制系统在PD早期就已受到影响这一假设。此外，我们还确定了PD患者中立体视觉功能障碍的病例。
我们检查了23例早期PD患者和23名年龄、性别匹配的健康对照者。使用加速度计在下脊柱的质心处测量姿势摆动。受试者被要求在两种常规条件（睁眼和闭眼）和两种双重任务条件（睁眼执行双重任务、闭眼执行双重任务）下安静站立30秒。使用Titmus飞蝇试验评估立体视觉。
在常规条件下，对照组和PD组之间未发现差异。随着任务难度增加，与对照受试者相比，PD患者的摆动加速度均方根（RMS）值增加。这些差异在认知任务执行期间具有统计学意义。随着摆动任务难度增加，PD患者的急动度（JERK）值更大，在认知任务执行期间也具有统计学意义。相对于对照组，PD患者的立体视觉功能下降。但是，即使在认知任务执行期间，Titmus试验的弧秒对数与JERK之间也没有统计学上的显著相关性。
我们的结果表明，早期PD患者在注意力分散或减少时存在姿势不稳定的细微迹象。此外，立体视觉缺陷在早期PD患者中可能很常见。缩写：ACC：加速度计；ANOVA：方差分析；AP：前后方向；COP：压力中心；EC：闭眼；ECDT：闭眼执行双重任务；EO：睁眼；EODT：睁眼执行双重任务；GDS：老年抑郁量表；JERK：摆动急动度；ML：内外侧方向；MMSE：简易精神状态检查；MoCA：蒙特利尔认知评估；PD：帕金森病；PDAbS：立体视觉异常的PD患者；PDNrS：立体视觉正常的PD患者；PIGD：姿势不稳和步态障碍；RMS：均方根；UPDRS：统一帕金森病评定量表。
