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药物初治帕金森病患者的定量感觉测试 (QST)。

Quantitative Sensory Testing (QST) in Drug-Naïve Patients with Parkinson's Disease.

机构信息

Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

Department of Neurology, University Hospital Essen, University Duisburg-Essen, Essen, Germany.

出版信息

J Parkinsons Dis. 2019;9(2):369-378. doi: 10.3233/JPD-181513.

Abstract

BACKGROUND

Pain is highly prevalent in patients with Parkinson's disease (PD), but underlying pathophysiological mechanisms are largely unclear. Alterations in somatosensory processing might contribute to sensory abnormalities in PD.

OBJECTIVE

This study investigated sensory processing in PD patients.

METHODS

We used the standardized "Quantitative Sensory Testing" (QST) protocol (German Research Network on Neuropathic Pain) to investigate 13 somatosensory parameters in 19 PD patients naïve to dopaminergic medication and 19 healthy controls matched for age, gender, and handedness. We tested for differences in sensory parameters between i) drug-naïve PD patients and healthy controls, ii) patients' more and less affected body side, and iii) for an association of somatosensory parameters with disease-specific factors.

RESULTS

We did not observe any significant group differences in somatosensory parameters between PD patients and healthy subjects. In PD patients, QST mean z-scores did not differ between the predominantly and the less affected body side, PD patients with and without PD-specific chronic pain or between different PD subtypes. Age, but not PD disease severity, was associated with a greater loss of function in thermal and mechanical detection thresholds.

CONCLUSIONS

Somatosensory processing, as assessed with the well-established QST protocol, was normal in drug-naïve PD patients. Thus, somatosensory abnormalities previously reported in medicated PD patients might rather be a result of dopaminergic medication, or may occur later in the course of the disease or with increasing age.

摘要

背景

帕金森病(PD)患者疼痛发生率高,但潜在的病理生理机制尚不清楚。躯体感觉处理的改变可能导致 PD 中的感觉异常。

目的

本研究旨在调查 PD 患者的感觉处理情况。

方法

我们使用标准化的“定量感觉测试”(QST)方案(德国神经病理性疼痛研究网络),对 19 例未经多巴胺能药物治疗的 PD 患者和 19 名年龄、性别和惯用手匹配的健康对照者进行了 13 项躯体感觉参数的检测。我们测试了 i)未经药物治疗的 PD 患者与健康对照者之间、ii)患者身体更受影响侧与身体较不受影响侧之间、iii)躯体感觉参数与疾病特异性因素之间的差异。

结果

我们未观察到 PD 患者与健康受试者之间在躯体感觉参数方面存在任何显著的组间差异。在 PD 患者中,QST 平均 z 评分在主要受影响侧与次要受影响侧之间、有和无 PD 特异性慢性疼痛的患者之间以及不同 PD 亚型之间均无差异。年龄而不是 PD 疾病严重程度与热觉和机械检测阈值的功能丧失程度更大相关。

结论

使用成熟的 QST 方案评估的躯体感觉处理在未经药物治疗的 PD 患者中是正常的。因此,先前在接受药物治疗的 PD 患者中报道的躯体感觉异常可能是多巴胺能药物治疗的结果,或者可能在疾病的后期或随着年龄的增长而发生。

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