Department of Neurology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
J Parkinsons Dis. 2019;9(2):405-411. doi: 10.3233/JPD-191578.
Trouble concentrating during orthostasis is one symptom of orthostatic hypotension (OH), but it is often ignored in clinical practice because OH incorporates many nonspecific symptoms. Blunted cognition during orthostasis may affect various aspects of the clinical status of patients with Parkinson's disease (PD), but its impact on drug-naïve, early PD patients is not clear.
This study investigated the association between trouble concentrating during orthostasis and orthostatic blood pressure changes and the influence of trouble concentrating during orthostasis on other non-motor symptoms and health-related quality of life in de novo PD.
A total of 124 patients with early PD were enrolled and received a structured clinical interview, physical examination, and validated questionnaires to evaluate motor and non-motor symptoms and quality of life. Disturbed concentration was evaluated with question 5 of the Orthostatic Hypotension Questionnaire system assessment (part I). Supine blood pressure and blood pressure change during tilt table testing were recorded, and any association was analyzed.
Among the study population, 76 (61.3%) patients had trouble concentrating. Patients with blunted concentration had a steeper decrease in blood pressure during orthostasis. The score for trouble concentrating was positively associated with non-motor symptoms and quality of life scores.
Trouble concentrating when standing was a frequent finding in early, drug-naïve PD patients. It was positively associated with non-motor burden, mood and quality of life in patients with PD. OH was correlated with the incidence of trouble concentrating. Such findings complicate treatment but provide valuable information for managing early PD.
在直立位时注意力不集中是直立性低血压（OH）的一种症状，但在临床实践中常被忽视，因为 OH 包含许多非特异性症状。直立位时认知功能障碍可能会影响帕金森病（PD）患者的各个临床方面，但对未经药物治疗的早期 PD 患者的影响尚不清楚。
本研究调查了直立位时注意力不集中与直立位血压变化之间的关系，以及直立位时注意力不集中对未经药物治疗的早期 PD 患者的其他非运动症状和健康相关生活质量的影响。
共纳入 124 例早期 PD 患者，进行了结构化临床访谈、体格检查和经过验证的问卷评估运动和非运动症状以及生活质量。使用直立性低血压问卷系统评估（第 I 部分）的问题 5 评估注意力不集中。记录仰卧位血压和倾斜试验期间的血压变化，并分析任何关联。
在研究人群中，76 例（61.3%）患者注意力不集中。注意力不集中的患者在直立位时血压下降更为陡峭。注意力不集中的评分与非运动症状和生活质量评分呈正相关。
在未经药物治疗的早期 PD 患者中，直立时注意力不集中是一种常见的发现。它与 PD 患者的非运动负担、情绪和生活质量呈正相关。OH 与注意力不集中的发生率相关。这些发现使治疗复杂化，但为管理早期 PD 提供了有价值的信息。
