未明原因帕金森病和震颤中运动外症状的负担：一项使用 [I]FP-CIT SPECT 的研究。
Burden of non-motor symptoms in unclear parkinsonism and tremor: A study with [I]FP-CIT SPECT.
机构信息
Division of Clinical Neurosciences, Turku University Hospital, Turku, Finland; Department of Neurology, University of Turku, Turku, Finland.
Division of Clinical Neurosciences, Turku University Hospital, Turku, Finland; Department of Neurology, University of Turku, Turku, Finland; Turku Brain and Mind Center, University of Turku, Turku, Finland.
出版信息
J Neurol Sci. 2019 Sep 15;404:124-127. doi: 10.1016/j.jns.2019.07.025. Epub 2019 Jul 19.
BACKGROUND
Non-motor symptoms (NMSs) are clearly more prevalent in Parkinson's disease (PD) patients compared to healthy individuals. However, NMSs are also common in the elderly and other neurological conditions, and thus, it is not known whether NMSs could be used to differentiate PD from parkinsonism/tremor without dopamine deficiency.
METHODS
We prospectively evaluated NMSs immediately before brain dopamine transporter (DAT) [I]FP-CIT SPECT scanning in 193 patients with unclear parkinsonism/tremor. According to the clinical follow-up and imaging results, 84 patients had PD. NMSs and their correlations with striatal DAT binding were investigated in PD patients and in parkinsonism/tremor patients with normal dopamine function.
RESULTS
Total NMS burden, anxiety or depression did not differ between PD patients and patients with normal DAT binding. DAT-normal patients reported more perception-related (p = 0.045) and attention/memory-related NMSs than PD patients (p < 0.001). Total NMS score did not correlate with striatal DAT binding in either group.
CONCLUSIONS
In clinically uncertain cases, the total NMS burden cannot be used as a tool in distinguishing PD patients from patients with non-dopaminergic parkinsonism/tremor. Clinical screening of NMSs appears equally important in all patients with parkinsonism.
背景
与健康个体相比，非运动症状（NMSs）在帕金森病（PD）患者中更为常见。然而，NMSs 在老年人和其他神经疾病中也很常见，因此，尚不清楚 NMSs 是否可用于区分无多巴胺缺乏的 PD 与帕金森症/震颤。
方法
我们前瞻性地评估了 193 例不明原因帕金森症/震颤患者在大脑多巴胺转运体（DAT）[I]FP-CIT SPECT 扫描前的 NMSs。根据临床随访和影像学结果，84 例患者为 PD。我们在 PD 患者和多巴胺功能正常的帕金森症/震颤患者中研究了 NMSs 及其与纹状体 DAT 结合的相关性。
结果
PD 患者与 DAT 正常的患者之间，总 NMS 负担、焦虑或抑郁无差异。与 PD 患者相比，DAT 正常的患者报告了更多与感知相关的（p=0.045）和注意力/记忆相关的 NMSs（p<0.001）。在两组患者中，总 NMS 评分均与纹状体 DAT 结合无相关性。
结论
在临床不确定的情况下，总 NMS 负担不能作为区分 PD 患者与非多巴胺能帕金森症/震颤患者的工具。在所有帕金森症患者中，对 NMSs 的临床筛查似乎同样重要。
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