Deng Xiao, Xiao Bin, Li Hui-Hua, Ng Ebonne, Lo Yew-Long, Tan Eng-King, Prakash Kumar M
Department of Neurology, National Neuroscience Institute, Singapore General Hospital, Singapore, Singapore.
Health Services Research Unit, Singapore General Hospital, Singapore, Singapore.
Front Neurol. 2020 Jan 17;10:1379. doi: 10.3389/fneur.2019.01379. eCollection 2019.
In a prospective 4-year study, we evaluated the progression of motor and non-motor symptoms in Parkinson's disease (PD) patients with Asian-specific risk variants and non-carriers. A total of 202 patients with PD, including 133 risk variant carriers and 69 non-carriers, were followed up and evaluated using the Modified Hoehn and Yahr staging scale, Unified Parkinson's Disease Rating Scale part III, Non-motor Symptom Scale, Parkinson's disease Questionnaire-39 item version. Means of generalized estimating equation model was performed to compare the differences from baseline between risk variant carriers and non-carriers. Our longitudinal analysis revealed that risk variant carriers exhibited greater progression than non-carriers after 4 years based on the modified Hoehn and Yahr staging scale (risk variants carriers, 0.65; non-carriers, 0.06; = 0.041). Meanwhile, Unified Parkinson's Disease Rating Scale gait and posture score in risk variant carriers also showed greater increase than that in non-carriers, although the difference was not statistically significant. Non-carriers experienced a transient improvement in non-motor symptoms at the early stage of PD, as scores at visit two significantly reduced compared to baseline in Non-motor Symptom Scale domain 3 (mood/apathy), Parkinson's disease Questionnaire-39 item version domain 3 (emotional well-being), and frequency of NMS in non-carriers but not in risk variants carriers. PD gene risk variant carriers were more likely to progress faster in their motor severity than non-carriers. There were transient differences in certain non-motor symptoms and quality of life in carriers. However, more studies are warranted to assess the association of PD risk variants and progression of non-motor symptoms.
在一项为期4年的前瞻性研究中，我们评估了携带亚洲特异性风险变异的帕金森病（PD）患者和非携带者运动及非运动症状的进展情况。共有202例PD患者，包括133例风险变异携带者和69例非携带者，采用改良Hoehn和Yahr分期量表、统一帕金森病评定量表第三部分、非运动症状量表、帕金森病问卷39项版本进行随访和评估。采用广义估计方程模型的均值来比较风险变异携带者和非携带者与基线之间的差异。我们的纵向分析显示，基于改良Hoehn和Yahr分期量表，4年后风险变异携带者的进展比非携带者更大（风险变异携带者为0.65；非携带者为0.06；P = 0.041）。同时，风险变异携带者的统一帕金森病评定量表步态和姿势评分也比非携带者有更大的增加，尽管差异无统计学意义。非携带者在PD早期非运动症状有短暂改善，因为在非运动症状量表领域3（情绪/淡漠）、帕金森病问卷39项版本领域3（情绪健康）以及非携带者而非风险变异携带者的非运动症状频率方面，第二次就诊时的评分与基线相比显著降低。PD基因风险变异携带者的运动严重程度比非携带者更有可能进展得更快。携带者在某些非运动症状和生活质量方面存在短暂差异。然而，需要更多研究来评估PD风险变异与非运动症状进展之间的关联。
