Liu Jiang-Bing, Leng Jun-Ling, Wang Ying-Ge, Zhang Yu, Tang Tie-Yu, Tao Li-Hong, Zhang Xin-Jiang, Liu Chun-Feng
Department of Neurology, The Affiliated Hospital of Yangzhou University, Yangzhou University, Jiangsu, China.
Emergency Department, The Affiliated Hospital of Yangzhou University, Yangzhou University, Jiangsu, China.
Parkinsons Dis. 2019 Jan 2;2019:1654161. doi: 10.1155/2019/1654161. eCollection 2019.
Nonmotor symptoms (NMS) are prodromal characteristics of Parkinson's disease (PD). The first-degree relatives (FDR) of PD patients had a higher risk of PD and also had more NMS.
To delineate NMS in FDR of patients with different clinical types of PD.
A total of 98 PD probands were recruited; 256 siblings of them were enrolled in the FDR group. Various scales were used to assess NMS, including depression, anxiety, cognitive impairment, insomnia, constipation, excessive daytime sleepiness, rapid eye movement sleep behavior disorder (RBD), and restless legs syndrome (RLS). The incidences of NMS were further compared between the FDR groups of PD with different types.
The FDR of early-onset PD (EOP) showed a higher incidence of moderate to severe depression (OR = 4.08; 95% CI: 1.12-14.92; =0.033), anxiety (OR = 4.22; 95% CI: 1.87-9.52; =0.001), and excessive daytime sleepiness (OR = 3.40; 95% CI: 1.00-11.48; =0.049) than the FDR of late-onset PD (LOP). It was also found that RBD (OR = 11.65; 95% CI: 3.82-35.54; < 0.001), constipation (OR = 4.94; 95% CI: 1.85-13.21; =0.001), sleep disorders (OR = 4.51; 95% CI: 1.73-11.78; =0.002), cognitive impairment (OR = 3.55; 95% CI: 1.62-7.77; =0.002), and anxiety (OR = 2.49; 95% CI: 1.32-4.71; =0.005) were more frequent in FDR of tremor-dominant PD (TDP) than in FDR of non-tremor-dominant PD (NTDP).
The siblings of patients with EOP and TDP have more NMS, presuming that they have a higher risk in the PD prodromal stage. Whether they have a greater possibility to progress into PD requires further investigation.
非运动症状（NMS）是帕金森病（PD）的前驱特征。PD患者的一级亲属（FDR）患PD的风险更高，且非运动症状更多。
描述不同临床类型PD患者FDR中的非运动症状。
共招募98名PD先证者；他们的256名兄弟姐妹被纳入FDR组。使用各种量表评估非运动症状，包括抑郁、焦虑、认知障碍、失眠、便秘、日间过度嗜睡、快速眼动睡眠行为障碍（RBD）和不安腿综合征（RLS）。进一步比较不同类型PD的FDR组中非运动症状的发生率。
早发型PD（EOP）的FDR中，中重度抑郁（OR = 4.08；95%CI：1.12 - 14.92；P = 0.033）、焦虑（OR = 4.22；95%CI：1.87 - 9.52；P = 0.001）和日间过度嗜睡（OR = 3.40；95%CI：1.00 - 11.48；P = 0.049）的发生率高于晚发型PD（LOP）的FDR。还发现，震颤为主型PD（TDP）的FDR中，RBD（OR = 11.65；95%CI：3.82 - 35.54；P < 0.001）、便秘（OR = 4.94；95%CI：1.85 - 13.21；P = 0.001）、睡眠障碍（OR = 4.5�1；95%CI：1.73 - 11.78；P = 0.002）、认知障碍（OR = 3.55；95%CI：1.62 - 7.77；P = 0.002）和焦虑（OR = 2.49；95%CI：1.32 - 4.71；P = 0.005）比非震颤为主型PD（NTDP）的FDR更常见。
EOP和TDP患者的兄弟姐妹有更多的非运动症状，推测他们在PD前驱期有更高风险。他们是否更有可能进展为PD需要进一步研究。
