帕金森病中冻结步态对运动表型功能依赖的影响。
The impact of freezing of gait on functional dependency in Parkinson's disease with regard to motor phenotype.
作者信息
Santos-García Diego, de Deus-Fonticoba Teres, Suárez Castro Ester, M Aneiros Díaz Ángel, Feal-Painceiras María J, Paz-González Jose M, García-Sancho Carlos, Jesús Silvia, Mir Pablo, Planellas Lluís, García-Caldentey Juan, Caballol Nuria, Legarda Inés, Hernández-Vara Jorge, González-Aramburu Isabel, Ávila-Rivera María A, Catalán María J, Nogueira Víctor, Álvarez-Sauco María, Vela Lydia, Escalante Sonia, Cubo Esther, Sánchez-Alonso Pilar, Alonso-Losada María G, López-Ariztegui Nuria, Martinez-Martin Pablo
机构信息
Section of Neurology, Complejo Hospitalario Universitario de A Coruña (CHUAC), HUAC, C / As Xubias 84, 15006, A Coruña, Spain.
Hospital Arquitecto Marcide y Hospital Naval, Complejo Hospitalario Universitario de Ferrol (CHUF), Ferrol, A Coruña, Spain.
出版信息
Neurol Sci. 2020 Oct;41(10):2883-2892. doi: 10.1007/s10072-020-04404-7. Epub 2020 Apr 24.
BACKGROUND AND OBJECTIVE
Freezing of gait (FOG) is a disabling symptom more frequent in Parkinson's disease (PD) patients with postural instability gait difficulty (PIGD) phenotype. The aim of this study was to determine the prevalence of self-reported FOG in a large group of PD patients as well as assess its relationship with functional dependency with regard to motor phenotype.
METHODS
The data correspond to the baseline evaluation of the COPPADIS-2015 study. Patients with FOG were identified as those with a score of 1 or greater on item-3 of the freezing of gait questionnaire (FOG-Q). Functional dependency was defined as a Schwab and England (S&E) ADL scale score less than 80%. PIGD and non-PIGD (tremor dominant + indeterminate) groups were considered regarding to motor phenotype.
RESULTS
Among the 689 PD patients (62.6 ± 8.9 years old, 59.8% males), 240 reported FOG (34.8%), whereas 63 presented functional dependency (9.1%). A total of 22.1% of patients with FOG presented functional dependency vs. only 2.2% of those without FOG (p < 0.0001). FOG was related to functional dependency (OR = 3.470; 95%CI 1.411-8.530; p = 0.007) after adjustment to age, gender, disease duration, daily equivalent levodopa dose, comorbidity (number of non-antiparkinsonian drugs/day), motor status (UPDRS-III), PIGD phenotype, motor complications (UPDRS-IV), NMS burden (NMSS total score), cognition (PD-CRS), and mood (BDI-II). However, according to motor phenotype, FOG was related to functional dependency only in PIGD patients (OR = 7.163; 95%CI 1.206-42.564; p = 0.030).
CONCLUSIONS
Self-reported FOG is associated with functional dependency in PIGD but not in non-PIGD motor phenotype patients.
背景与目的
冻结步态（FOG）是姿势不稳步态障碍（PIGD）型帕金森病（PD）患者中更常见的致残症状。本研究的目的是确定一大群PD患者中自我报告的FOG患病率，并评估其与运动表型的功能依赖性之间的关系。
方法
数据来自COPPADIS - 2015研究的基线评估。FOG患者被定义为在冻结步态问卷（FOG - Q）第3项上得分≥1分的患者。功能依赖性定义为施瓦布和英格兰（S&E）日常生活活动量表得分低于80%。根据运动表型考虑PIGD组和非PIGD组（震颤为主型+不确定型）。
结果
在689例PD患者（年龄62.6±8.9岁，男性占59.8%）中，240例报告有FOG（34.8%），而63例存在功能依赖性（9.1%）。FOG患者中共有22.1%存在功能依赖性，而无FOG患者中仅为2.2%（p<0.0001）。在对年龄、性别、病程、每日左旋多巴等效剂量、合并症（每日非抗帕金森病药物数量）、运动状态（统一帕金森病评定量表第三部分[UPDRS - III]）、PIGD表型、运动并发症（UPDRS - IV）、非运动症状负担（非运动症状量表总分）、认知（帕金森病认知量表[PD - CRS]）和情绪（贝克抑郁量表第二版[BDI - II]）进行调整后，FOG与功能依赖性相关（比值比[OR]=3.470；95%置信区间[CI] 1.411 - 8.530；p = 0.007）。然而，根据运动表型，FOG仅在PIGD患者中与功能依赖性相关（OR = 7.163；95%CI 1.206 - 42.564；p = 0.030）。
结论
自我报告的FOG与PIGD患者的功能依赖性相关，但与非PIGD运动表型患者无关。
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