Neurosciences Research Centre, Molecular and Clinical Sciences Research Institute, St George's University of London, London, UK.
Nuffield Department of Clinical Neurosciences, MRC Brain Network Dynamics Unit, Oxford, UK.
Eur J Neurol. 2020 Dec;27(12):2422-2429. doi: 10.1111/ene.14452. Epub 2020 Aug 20.
Hypomimia is a prominent clinical feature in people with Parkinson's disease (PD), but it remains under-investigated. We aimed to examine the clinical correlates of hypomimia in PD and to determine whether this is a levodopa-responsive sign.
We included 89 people with PD. Hypomimia was assessed from digital video recordings by movement disorder specialists. Clinical evaluation included use of the Unified Parkinson's Disease Rating Scale part III (UPDRS-III), and assessment of motor and non-motor symptoms using standardized clinical scales. The relationships between hypomimia and other clinical data were analysed using Mann-Whitney U-tests and regression analysis.
Hypomimia occurred in up to 70% of patients with PD. Patients with hypomimia had worse UPDRS-III 'off-medication' scores, mainly driven by bradykinesia and rigidity subscores. Patients with hypomimia also had worse apathy than patients without hypomimia. Finally, we found that hypomimia was levodopa-responsive and its improvement mirrored the change by levodopa in axial motor symptoms.
Our study provides novel information regarding the clinical correlates of hypomimia in people with PD. A better understanding of hypomimia may be relevant for improving treatment and quality of life in PD.
运动减少是帕金森病（PD）患者的一个突出临床特征，但目前对此研究较少。本研究旨在探讨 PD 患者运动减少的临床相关性，并确定其是否为一种对左旋多巴治疗有反应的征象。
我们纳入了 89 名 PD 患者。运动减少通过运动障碍专家的数字视频记录进行评估。临床评估包括使用统一帕金森病评定量表第 3 部分（UPDRS-III），以及使用标准化临床量表评估运动和非运动症状。采用 Mann-Whitney U 检验和回归分析对运动减少与其他临床数据之间的关系进行分析。
多达 70%的 PD 患者存在运动减少。运动减少的患者“未服药”时 UPDRS-III 评分更差，主要由运动迟缓和僵硬子评分驱动。运动减少的患者比无运动减少的患者更易出现淡漠。最后，我们发现运动减少对左旋多巴治疗有反应，其改善程度与左旋多巴对轴性运动症状的改善程度一致。
本研究提供了 PD 患者运动减少的临床相关性的新信息。更好地了解运动减少可能与改善 PD 的治疗和生活质量相关。
