Department of Rehabilitation Medicine, the First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China.
Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi, China.
BMC Neurol. 2019 Dec 1;19(1):309. doi: 10.1186/s12883-019-1535-8.
The mechanisms underlying the online modulation of motor speech in Parkinson's disease (PD) have not been determined. Moreover, medical and rehabilitation interventions for PD-associated motor speech disorder (MSD) have a poor long-term prognosis.
To compare risk factors in PD patients with MSD to those without MSD (non-MSD) and determine predictive independent risk factors correlated with the MSD phenotype, we enrolled 314 PD patients, including 250 with and 64 without MSD. We compared demographic, characteristic data, as well as PD-associated evaluations between the MSD group and non-MSD group.
Univariate analysis showed that demographic characteristics, including occupation, educational level, monthly income and speaking background; clinical characteristics, including lesions in the frontal and temporal lobes, and concurrent dysphagia; and PD-associated evaluations, including the activity of daily living (ADL) score, non-motor symptoms scale (NMSS) domain 4 score (perceptual problem), and NMSS domain 5 score (attention/memory) were all significantly different between the MSD and non-MSD group (all P < 0.05). Multivariate logistic regression analysis showed that educational level, frontal lesions, and NMSS domain 5 score (attention/memory) were independent risk factors for PD-associated MSD (all P < 0.005).
We determined an association between MSD phenotype and cognitive impairment, reflected by low-level education and related clinical profiles. Moreover, attention and memory dysfunction may play key roles in the progression of MSD in PD patients. Further studies are required to detail the mechanism underlying abnormal speech motor modulation in PD patients. Early cognitive intervention may enhance rehabilitation management and motor speech function in patients with PD-associated MSD.
帕金森病(PD)患者在线调节运动言语的机制尚未确定。此外,针对与 PD 相关的运动言语障碍(MSD)的医学和康复干预措施的长期预后较差。
为了比较有 MSD 的 PD 患者与无 MSD(非 MSD)患者的危险因素,并确定与 MSD 表型相关的预测独立危险因素,我们纳入了 314 例 PD 患者,其中 250 例有 MSD,64 例无 MSD。我们比较了 MSD 组和非 MSD 组之间的人口统计学、特征数据以及与 PD 相关的评估。
单因素分析显示,人口统计学特征,包括职业、教育程度、月收入和说话背景;临床特征,包括额叶和颞叶病变以及并存的吞咽困难;以及与 PD 相关的评估,包括日常生活活动(ADL)评分、非运动症状量表(NMSS)第 4 域评分(感知问题)和 NMSS 第 5 域评分(注意力/记忆)在 MSD 组和非 MSD 组之间均有显著差异(均 P<0.05)。多因素逻辑回归分析显示,教育程度、额叶病变和 NMSS 第 5 域评分(注意力/记忆)是 PD 相关 MSD 的独立危险因素(均 P<0.005)。
我们确定了 MSD 表型与认知障碍之间的关联,认知障碍表现为低水平教育和相关的临床特征。此外,注意力和记忆功能障碍可能在 PD 患者 MSD 的进展中起关键作用。需要进一步研究来详细阐述 PD 患者异常言语运动调节的机制。早期认知干预可能会增强 PD 相关 MSD 患者的康复管理和言语运动功能。