Zhang Yuan, Shu Li, Zhou Xun, Pan Hongxu, Xu Qian, Guo Jifeng, Tang Beisha, Sun Qiying
Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China.
National Clinical Research Center for Geriatric Disorders, Changsha, Hunan 410078, China.
Parkinsons Dis. 2018 Sep 27;2018:3136415. doi: 10.1155/2018/3136415. eCollection 2018.
gene had been proved to be a crucial gene to the risk of PD. Numerous studies had discussed about the unique clinical characteristics of PD patients with carriers ( + PD). However, there was lack of updated comprehensive analysis on the topic. In order to clarify the association between variants and the clinical phenotypes of PD, we conducted this comprehensive meta-analysis.
Medline, Embase, and Cochrane were used to perform the searching. Strict selection criteria were followed in screening for new published articles or data. Revman 5.3 software was applied to perform the total statistical analysis, and funnel plots in the software were used to assess the publication biases.
A total of 26 articles including 931 + PD and 14861 noncarriers of PD ( - PD) were involved in the final meta-analysis, and 14 of them were either newly added publications or related data newly analyzed compared with the version published in 2015. Then, a series of symptoms containing depression, orthostatic hypotension, motor fluctuation, wearing-off, and freezing were newly analyzed due to more articles eligible. Besides, clinical features like family history, AAO, UPDRS-III, H-Y, and dementia previously analyzed were updated with new data added. Significant statistical differences were found in wearing-off, family history, AAO, UPDRS-III, and dementia (OR: 1.14, 1.65; MD: -3.61, 2.17; OR: 2.44; : 0.03, <0.00001, <0.00001, 0.003, and <0.00001). Depression was slightly associated with + PD (OR: 1.47; : 0.04). Clinical symptoms such as H-Y, orthostatic hypotension, motor fluctuation, and freezing did not feature + PD.
Our results demonstrated that there were unique clinical features in + PD which can help the management of the whole duration of PD patients.
基因已被证明是帕金森病（PD）风险的关键基因。众多研究探讨了携带该基因的PD患者（+PD）独特的临床特征。然而，目前缺乏对该主题的最新综合分析。为了阐明该基因变异与PD临床表型之间的关联，我们进行了这项综合荟萃分析。
使用Medline、Embase和Cochrane进行检索。在筛选新发表的文章或数据时遵循严格的选择标准。应用Revman 5.3软件进行总体统计分析，并使用该软件中的漏斗图评估发表偏倚。
最终的荟萃分析共纳入26篇文章，包括931例+PD患者和14861例非携带者（-PD），其中14篇与2015年发表版本相比为新增加的出版物或新分析的相关数据。然后，由于符合条件的文章增多，对包括抑郁、体位性低血压、运动波动、剂末现象和冻结现象在内的一系列症状进行了新的分析。此外，之前分析过的家族史、发病年龄（AAO）、统一帕金森病评定量表第三部分（UPDRS-III）、 Hoehn-Yahr分级（H-Y）和痴呆等临床特征也更新了新添加的数据。在剂末现象、家族史、AAO、UPDRS-III和痴呆方面发现了显著的统计学差异（比值比：1.14、1.65；均差：-3.61、2.17；比值比：2.44；P值：0.03、<0.00001、<0.00001、0.003和<0.00001）。抑郁与+PD有轻微关联（比值比：1.47；P值：0.04）。H-Y、体位性低血压、运动波动和冻结现象等临床症状在+PD中无特征性表现。
我们的结果表明，+PD存在独特的临床特征，这有助于对PD患者的整个病程进行管理。
