Xue Fei, Wang Fu-Yu, Mao Cheng-Jie, Guo Si-Ping, Chen Jing, Li Jie, Wang Qiao-Jun, Bei Hong-Zhe, Yu Qian, Liu Chun-Feng
Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou 215004, China; Emergency Department, Jiangyin Hospital of Traditional Chinese Medicine, Wuxi 214400, China.
Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou 215004, China.
J Clin Neurosci. 2018 Aug;54:96-101. doi: 10.1016/j.jocn.2018.06.016. Epub 2018 Jun 13.
Nocturnal hypokinesia/akinesia and sleep disorder are believed to be common in Parkinson's disease (PD), but are often underestimated. To date, only a few studies have focused on nocturnal symptoms related to motor function and sleep quality in PD patients, and the assessments were based mainly on the subjective descriptions of the patients. In this study, we assessed the relationships between motor symptoms and sleep quality in 29 PD patients (17 PD patients reporting impaired bed mobility (IBM) and 12 patients without IBM). All the participants were monitored using multisite inertial sensors and polysomnography in sleep-monitoring rooms for whole night. Compared with PD-IBM patients, PD+IBM patients tended to have fewer turning-over episodes and smaller degree turns. Meanwhile, PD+IBM patients had worse Pittsburgh Sleep Quality Index (PSQI) and Parkinson's Disease Sleep Scale (PDSS) scores, and less total sleep time (TST) than PD-IBM patients. Spearman correlation analyses found that the number of turning-over events showed negative correlations with disease duration (r = -0.378, P < 0.05) and Unified Parkinson's Disease Rating Scale (UPDRS) axial scores (r = -0.370, P < 0.05). Moreover, TST (r = 0.505, p < 0.05) and sleep efficiency (SE) (r = 0.473, p < 0.05) positively correlated with the number of turns in bed. Multivariate linear regression analyses showed that UPDRS axial scores and the number of turns were significantly associated with TST (both p < 0.05). In conclusion, the number of turns in bed and UPDRS axial scores were two significant factors affecting sleep quality. Multisite inertial sensors can be used to quantitatively evaluate nocturnal motor functions in PD patients.
夜间运动功能减退/运动不能和睡眠障碍在帕金森病（PD）中被认为很常见，但往往被低估。迄今为止，仅有少数研究关注PD患者中与运动功能和睡眠质量相关的夜间症状，且评估主要基于患者的主观描述。在本研究中，我们评估了29例PD患者（17例报告存在床上活动障碍（IBM）的PD患者和12例无IBM的患者）的运动症状与睡眠质量之间的关系。所有参与者均在睡眠监测室使用多部位惯性传感器和多导睡眠图进行整夜监测。与PD-IBM患者相比，PD+IBM患者往往翻身次数更少且翻身幅度更小。同时，PD+IBM患者的匹兹堡睡眠质量指数（PSQI）和帕金森病睡眠量表（PDSS）得分更差，总睡眠时间（TST）比PD-IBM患者更少。Spearman相关性分析发现，翻身事件的数量与病程（r = -0.378，P < 0.05）和统一帕金森病评定量表（UPDRS）轴向评分（r = -0.370，P < 0.05）呈负相关。此外，TST（r = 0.505，p < 0.05）和睡眠效率（SE）（r = 0.473，p < 0.05）与床上翻身次数呈正相关。多元线性回归分析表明，UPDRS轴向评分和翻身次数与TST均显著相关（均P < 0.05）。总之，床上翻身次数和UPDRS轴向评分是影响睡眠质量的两个重要因素。多部位惯性传感器可用于定量评估PD患者的夜间运动功能。
