Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Gangnam-gu, Seoul, Republic of Korea.
Neuroscience Center, Samsung Medical Center, Gangnam-gu, Seoul, Republic of Korea.
J Parkinsons Dis. 2020;10(2):605-612. doi: 10.3233/JPD-201919.
Fatigue is a common and disabling non-motor symptom in Parkinson's disease (PD). Autonomic dysfunction is suggested as the possible pathophysiology of fatigue, but it has not been investigated in drug-naïve PD patients.
In the present study, the relationship between fatigue and autonomic dysfunction in drug-naïve PD patients was investigated.
In the present study, 89 drug-naïve PD patients were analyzed. The Parkinson's disease fatigue scale (PFS) was used to divide the patients into fatigue (mean PFS≥3.3) and non-fatigue groups (mean PFS < 3.3). The autonomic function test (AFT), Scale for Outcomes in Parkinson's Disease-Autonomic (SCOPA-AUT), Unified Parkinson's Disease Rating Scale (UPDRS)-I, -II, -III, modified Hoehn and Yahr (H&Y) scale, Montreal Cognitive Assessment (MoCA), Parkinson's Disease Questionnaire-39 (PDQ-39), Parkinson's Disease Sleep Scale (PDSS), and Beck Depress Index (BDI) were performed in all the participants. The AFT results and clinical scales were compared using multiple logistic regression analysis.
The prevalence of fatigue was 23.6% (n = 21) in drug-naïve PD patients. Total SCOPA-AUT score was higher in the fatigue group than in the non-fatigue group. The fatigue group had lower inspiratory:expiratory (I:E) ratio and Valsalva ratio. The prevalence of abnormal sympathetic skin response and orthostatic hypotension (OH) was 19% and 38.1%, respectively, in the fatigue group. Regression model analysis revealed that SCOPA-AUT and OH were the most related factor of fatigue in drug-naïve PD patients.
Autonomic dysfunction in drug-naïve PD patients was investigated using a subjective scale as well as objective tests. The results indicated that fatigue is associated with autonomic dysfunction, especially OH, in drug-naïve PD patients.
疲劳是帕金森病（PD）的一种常见且使人致残的非运动症状。自主神经功能障碍被认为是疲劳的可能病理生理学基础，但在未经药物治疗的 PD 患者中尚未进行研究。
本研究旨在探讨未经药物治疗的 PD 患者中疲劳与自主神经功能障碍之间的关系。
本研究分析了 89 例未经药物治疗的 PD 患者。使用帕金森病疲劳量表（PFS）将患者分为疲劳组（平均 PFS≥3.3）和非疲劳组（平均 PFS＜3.3）。所有参与者均进行了自主功能测试（AFT）、帕金森病自主功能量表（SCOPA-AUT）、统一帕金森病评定量表（UPDRS）-I、-II、-III、改良 Hoehn 和 Yahr（H&Y）量表、蒙特利尔认知评估量表（MoCA）、帕金森病问卷-39（PDQ-39）、帕金森病睡眠量表（PDSS）和贝克抑郁指数（BDI）。使用多因素逻辑回归分析比较 AFT 结果和临床量表。
在未经药物治疗的 PD 患者中，疲劳的患病率为 23.6%（n=21）。疲劳组的总 SCOPA-AUT 评分高于非疲劳组。疲劳组的吸气：呼气（I:E）比值和瓦尔萨尔瓦动作比值较低。疲劳组交感神经皮肤反应和直立性低血压（OH）异常的患病率分别为 19%和 38.1%。回归模型分析表明，SCOPA-AUT 和 OH 是未经药物治疗的 PD 患者中与疲劳最相关的因素。
本研究使用主观量表和客观测试对未经药物治疗的 PD 患者的自主神经功能进行了研究。结果表明，疲劳与未经药物治疗的 PD 患者的自主神经功能障碍，特别是 OH 有关。
