Hu Tao, Ou Ruwei, Liu Hui, Hou Yanbing, Wei Qianqian, Song Wei, Cao Bei, Chen Yongping, Yuan Xiaoqin, Shang Huifang
Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Department of Neurology, Chengdu Aerospace Hospital, Chengdu, Sichuan, China.
Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Clin Neurol Neurosurg. 2018 Dec;175:124-129. doi: 10.1016/j.clineuro.2018.11.001. Epub 2018 Nov 2.
This study aims to explore the gender and onset age-related differences of non-motor symptoms (NMS) and the determinants of quality of life (QoL) in a large cohort of Chinese drug-naïve Parkinson's disease (PD) patients.
A cross-sectional analysis of 569 drug-naïve PD patients was conducted. The frequency and severity of each NMS was evaluated by Non-Motor Symptom Scale (NMSS), which consists of 9 subdomains. PD Questionnaire-39 (PDQ-39) was used to assess the QoL of PD patients. A stepwise multiple regression model was used to explore the determinants of QoL.
A total of 552 patients (97.0%) exhibited at least one NMS. The three most common NMS were sleep/fatigue (74%), attention/memory (62.7%) and miscellaneous (62%). The frequencies of sleep/fatigue and mood/apathy were more prevalent in women and the frequencies of urinary and sexual dysfunction were more prevalent in men (P < 0.05). Patients with late-onset PD showed higher frequencies of perceptual problems/hallucinations, attention/memory, gastrointestinal, urinary, sexual dysfunction, and miscellaneous compared to patients with early-onset PD (P < 0.05). The multiple regression analysis model indicated that female, disease duration, UPDRS III score, depression, and NMSS subcores including sleep/fatigue, mood/apathy, attention/memory, and gastrointestinal were the determinants of QoL in patients with drug-naïve PD.
NMS was common in untreated PD patients. They are heterogeneous in patients with drug-naïve PD, which are dramatic determinants on decreased QoL in PD. Our results are beneficial for clinical management of NMS in drug-naïve PD.
本研究旨在探讨一大群未服用过药物的中国帕金森病(PD)患者非运动症状(NMS)的性别和发病年龄相关差异以及生活质量(QoL)的决定因素。
对569例未服用过药物的PD患者进行横断面分析。通过由9个亚领域组成的非运动症状量表(NMSS)评估每种NMS的频率和严重程度。使用帕金森病问卷-39(PDQ-39)评估PD患者的生活质量。采用逐步多元回归模型探讨生活质量的决定因素。
共有552例患者(97.0%)表现出至少一种NMS。三种最常见的NMS是睡眠/疲劳(74%)、注意力/记忆力(62.7%)和其他(62%)。睡眠/疲劳和情绪/淡漠的发生率在女性中更高,而泌尿和性功能障碍的发生率在男性中更高(P < 0.05)。与早发型PD患者相比,晚发型PD患者的感知问题/幻觉、注意力/记忆力、胃肠道、泌尿、性功能障碍及其他方面的发生率更高(P < 0.05)。多元回归分析模型表明,女性、病程、统一帕金森病评定量表第三部分(UPDRS III)评分、抑郁以及包括睡眠/疲劳、情绪/淡漠、注意力/记忆力和胃肠道在内的NMSS子核心是未服用过药物的PD患者生活质量的决定因素。
NMS在未治疗的PD患者中很常见。在未服用过药物的PD患者中它们具有异质性,是PD患者生活质量下降的重要决定因素。我们的结果有助于未服用过药物的PD患者NMS的临床管理。