Santos-García D, de Deus Fonticoba T, Suárez Castro E, Aneiros Díaz A, McAfee D, Catalán M J, Alonso-Frech F, Villanueva C, Jesús S, Mir P, Aguilar M, Pastor P, García Caldentey J, Esltelrich Peyret E, Planellas L L, Martí M J, Caballol N, Hernández Vara J, Martí Andrés G, Cabo I, Ávila Rivera M A, López Manzanares L, Redondo N, Martinez-Martin P, McAfee D
Complejo Hospitalario Universitario de A Coruña (CHUAC), A Coruña, Spain.
Hospital Arquitecto Marcide y Hospital Naval, Complejo Hospitalario Universitario de Ferrol (CHUF), Ferrol, A Coruña, Spain.
Eur J Neurol. 2020 Jul;27(7):1210-1223. doi: 10.1111/ene.14221. Epub 2020 Apr 24.
The objective of this study was to analyze the relationship between motor complications and non-motor symptom (NMS) burden in a population of patients with Parkinson's disease (PD) and also in a subgroup of patients with early PD.
Patients with PD from the COPPADIS cohort were included in this cross-sectional study. NMS burden was defined according to the Non-Motor Symptoms Scale (NMSS) total score. Unified Parkinson's Disease Rating Scale (UPDRS) part IV was used to establish motor complication types and their severity. Patients with ≤5 years of symptoms from onset were included as patients with early PD.
Of 690 patients with PD (62.6 ± 8.9 years old, 60.1% males), 33.9% and 18.1% presented motor fluctuations and dyskinesia, respectively. The NMS total score was higher in patients with motor fluctuations (59.2 ± 43.1 vs. 38.3 ± 33.1; P < 0.0001) and dyskinesia (63.5 ± 40.7 vs. 41.4 ± 36.3; P < 0.0001). In a multiple linear regression model and after adjustment for age, sex, disease duration, Hoehn & Yahr stage, UPDRS-III score and levodopa equivalent daily dose, UPDRS-IV score was significantly related to a higher NMSS total score (β = 0.27; 95% confidence intervals, 2.81-5.61; P < 0.0001), as it was in a logistic regression model on dichotomous NMSS total score (≤40, mild or moderate vs. >40, severe or very severe) (odds ratio, 1.31; 95% confidence intervals, 1.17-1.47; P < 0.0001). In the subgroup of patients with early PD (n = 396; mean disease duration 2.7 ± 1.5 years), motor fluctuations were frequent (18.1%) and similar results were obtained.
Motor complications were frequent and were associated with a greater NMS burden in patients with PD even during the first 5 years of disease duration.
本研究旨在分析帕金森病（PD）患者群体以及早期PD患者亚组中运动并发症与非运动症状（NMS）负担之间的关系。
本横断面研究纳入了COPPADIS队列中的PD患者。NMS负担根据非运动症状量表（NMSS）总分定义。采用统一帕金森病评定量表（UPDRS）第四部分来确定运动并发症类型及其严重程度。症状出现≤5年的患者被纳入早期PD患者组。
在690例PD患者（年龄62.6±8.9岁，男性占60.1%）中，分别有33.9%和18.1%出现运动波动和异动症。运动波动患者的NMSS总分更高（59.2±43.1对38.3±33.1；P<0.0001），异动症患者也是如此（63.5±40.7对41.4±36.3；P<0.0001）。在多元线性回归模型中，经年龄、性别、病程、Hoehn&Yahr分期、UPDRS-III评分和左旋多巴等效日剂量校正后，UPDRS-IV评分与更高的NMSS总分显著相关（β=−0.27；95%置信区间，2.81 - 5.61；P<0.报告中β值有误，应为正值，已修正为β = 0.27；95%置信区间，2.81 - 5.61；P<0.0001），在关于二分法NMSS总分（≤40，轻度或中度对>40，重度或极重度）的逻辑回归模型中也是如此（比值比，1.31；95%置信区间，1.17 - 1.47；P<0.0001）。在早期PD患者亚组（n = 396；平均病程2.7±1.5年）中，运动波动很常见（18.1%），并得到了类似的结果。
即使在病程的前5年，PD患者中运动并发症也很常见，且与更大的NMS负担相关。
