Sun Baihua, Wang Tao, Li Nianying, Qiao Jin
Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China.
Department of Neurology, The Sengong Hospital, Xi'an 710300, China.
Parkinsons Dis. 2020 Jul 29;2020:8692509. doi: 10.1155/2020/8692509. eCollection 2020.
Motor complications are common in Parkinson's disease (PD). The reported occurrence of motor complications varies across regions and races. The aim of our study was to describe the development of dyskinesias and motor fluctuations among Chinese PD patients and the relative risk factors.
In the current cross-sectional survey study, PD patients with motor fluctuations and dyskinesia were enrolled from March to November 2018 in Shaanxi province, a northwest area of China. Data were collected by the movement disorder specialists. A self-designed questionnaire was utilized during face-to-face interviews. In addition, the relevant factors of motor complications were analyzed by univariable and multivariable analyses.
Of the166 PD patients recruited, 52 (31.33%) and 25 (15.06%) patients had motor fluctuations and dyskinesia, respectively, which occurred in 6.76 ± 3.77 and 8.61 ± 4.46 years after the onset of motor symptoms and 5.37 ± 3.33 and 6.80 ± 3.43 years after the treatment of levodopa therapy, respectively. Patients with motor fluctuations and dyskinesias had longer disease duration, younger onset age, higher Hoehn-Yahr stages and UPDRS III scores, higher daily levodopa dosage and levodopa equivalent daily dose (LEDD), and longer duration of levodopa treatment ( < 0.05). Bradykinesia-rigidity dominant patients had higher incidences of motor fluctuations (61.54% vs 38.46%) and dyskinesias (68.00% vs 32.00%) than tremor-dominant patients ( < 0.05). Results of the multivariate logistic regression analyses showed that the duration of levodopa therapy, age of the onset, and bradykinesia-rigidity dominant type were independent risk factors of motor fluctuations ( < 0.05). In addition, duration of disease and bradykinesia-rigidity dominant type were independent risk factors of dyskinesia ( < 0.05).
The rate of motor fluctuations was higher than dyskinesias in Chinese patients with Parkinson's disease. Patients with younger age onset, bradykinesia-rigidity dominant type, longer disease duration, and longer duration of levodopa therapy are more likely to develop motor complications.
运动并发症在帕金森病(PD)中很常见。据报道,运动并发症的发生率在不同地区和种族间存在差异。我们研究的目的是描述中国PD患者中异动症和运动波动的发展情况以及相关危险因素。
在本次横断面调查研究中,2018年3月至11月从中国西北部地区陕西省招募了有运动波动和异动症的PD患者。数据由运动障碍专家收集。在面对面访谈期间使用自行设计的问卷。此外,通过单变量和多变量分析对运动并发症的相关因素进行分析。
在招募的166例PD患者中,分别有52例(31.33%)和25例(15.06%)患者出现运动波动和异动症,运动波动和异动症分别在运动症状出现后6.76±3.77年和8.61±4.46年出现,在左旋多巴治疗后5.37±3.33年和6.80±3.43年出现。有运动波动和异动症的患者病程更长、发病年龄更小、Hoehn-Yahr分期和统一帕金森病评定量表(UPDRS)III评分更高、每日左旋多巴剂量和左旋多巴等效日剂量(LEDD)更高以及左旋多巴治疗时间更长(P<0.05)。以运动迟缓-强直为主的患者比以震颤为主的患者发生运动波动(61.54%对38.46%)和异动症(68.00%对32.00%)的发生率更高(P<0.05)。多因素logistic回归分析结果显示,左旋多巴治疗时间、发病年龄以及以运动迟缓-强直为主的类型是运动波动的独立危险因素(P<0.05)。此外,病程和以运动迟缓-强直为主的类型是异动症的独立危险因素(P<0.05)。
中国帕金森病患者中运动波动的发生率高于异动症。发病年龄较小、以运动迟缓-强直为主的类型、病程较长以及左旋多巴治疗时间较长的患者更易发生运动并发症。