Department of Neurology, Hospital Eugenio Espejo, Quito, Ecuador.
Faculty of Medicine, Central University of Ecuador, Quito, Ecuador.
J Parkinsons Dis. 2020;10(3):1067-1073. doi: 10.3233/JPD-191851.
Recognition of motor signs in the prodromal stage could help identify those at risk of developing Parkinson's disease (PD).
This study identified motor symptoms and signs in individuals suspected of having PD but who did not have a progressive reduction in the speed and amplitude of finger tapping or other physical signs indicative of bradykinesia.
146 patients, who had symptoms or signs suggestive of PD, were serially evaluated by a movement disorder specialist, using the Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS) Part III and video recordings. If the patients 'converted' to PD during follow-up, they were categorized as cases and compared with those who did not meet PD criteria during follow-up (non-cases).
The 82 cases were more likely to have action dystonia or postural/action/rest tremor of a limb (OR 2.8; 95% CI 1.1-7.1; p = 0.02), a reduced blink rate at rest (OR 2.3; 95% CI 1.2-4.6; p = 0.01), anxiety (OR 8.9; 95% CI 2.6-31.1; p < 0.001), depression (OR 7.0; 95% CI 2.9-17.2; p < 0.001), or a frozen shoulder (OR 3.1; 95% CI 1.6-6.2) than the 64 'non-cases'.A reduction of the fast blink rate was common in patients who met the criteria for PD (p < 0.001).
This study emphasizes that motor dysfunction is a component of the clinical prodrome seen in some patients with PD.
在疾病前驱期识别运动体征有助于发现那些有发展为帕金森病（PD）风险的人。
本研究旨在识别那些有 PD 症状或体征但手指敲击速度和幅度无进行性下降或无其他运动迟缓迹象的个体的运动症状和体征。
146 名有 PD 症状或体征的患者由运动障碍专家使用运动障碍协会统一帕金森病评定量表（MDS-UPDRS）第三部分和视频记录进行连续评估。如果患者在随访中“转化”为 PD，则将其归类为病例，并与随访中未达到 PD 标准的患者（非病例）进行比较。
82 例病例更可能出现肢体动作性肌张力障碍或姿势/动作/休息性震颤（OR 2.8；95%CI 1.1-7.1；p=0.02）、静息时眨眼频率降低（OR 2.3；95%CI 1.2-4.6；p=0.01）、焦虑（OR 8.9；95%CI 2.6-31.1；p<0.001）、抑郁（OR 7.0；95%CI 2.9-17.2；p<0.001）或冻结肩（OR 3.1；95%CI 1.6-6.2），而非病例为 64 例。符合 PD 标准的患者快眨眼频率降低更为常见（p<0.001）。
本研究强调运动功能障碍是部分 PD 患者前驱期临床特征的一部分。
