Martinez-Ramirez Daniel, Velazquez-Avila Edna Sophia, Almaraz-Espinoza Alejandro, Gonzalez-Cantú Arnulfo, Vazquez-Elizondo Genaro, Overa-Posada Daniel, Cervantes-Arriaga Amin, Rodriguez-Violante Mayela, Gonzalez-Gonzalez Mirna
Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Ave. Morones Prieto 3000, Monterrey 64710, Nuevo Leon, Mexico.
Christus Muguerza Alta Especialidad, Ave. Hidalgo 2525, Monterrey 64060, Nuevo Leon, Mexico.
Parkinsons Dis. 2020 Oct 17;2020:1694547. doi: 10.1155/2020/1694547. eCollection 2020.
Autonomic dysfunction is a common nonmotor feature and early manifestation of Parkinsons disease (PD). Autonomic dysfunction in PD is associated with a worse prognosis. We sought to characterize autonomic dysfunction and identify associated factors in patients with early PD.
An observational, cross-sectional, descriptive, and analytical study was conducted to evaluate patients with early PD from the Parkinsons Progression Markers Initiative. We utilized the Scales for Outcomes in Parkinsons Disease-Autonomic dysfunction questionnaire to determine the prevalence and frequencies of autonomic symptomatology. The cohort was grouped into high and low dysautonomic scores. A regression model identified variables that independently explained dysautonomic scores in our early PD cohort.
414 PD patients had a mean age of 61.1 (SD 9.7) years at diagnosis and mean disease duration of 6.7 (SD 6.6) months. Among all patients, 43.7% (181/414) had high dysautonomic scores. Urinary and gastrointestinal symptoms were the most prevalent and frequently reported dysautonomic symptoms. Patients with fatigue (beta = 4.28, < 0.001), probable rapid eye movement sleep behavior disorder (beta = 2.71, < 0.001), excessive daytime sleepiness (beta = 1.88,=0.039), impulsivity and compulsivity (beta = 2.42, < 0.001), and increasing age (beta = 1.05, < 0.001) were more likely to have high dysautonomic scores.
Lower urinary tract and gastrointestinal symptoms are prevalent and frequent in early PD patients. Fatigue, sleep disorders, impulsivity and compulsivity, and age are predictors of autonomic dysfunction. Autonomic symptoms predominated in this group of early PD patients in the disease course and were associated with more severe disease.
自主神经功能障碍是帕金森病（PD）常见的非运动特征和早期表现。PD患者的自主神经功能障碍与较差的预后相关。我们旨在描述早期PD患者的自主神经功能障碍特征并确定相关因素。
进行了一项观察性、横断面、描述性和分析性研究，以评估帕金森病进展标志物计划中的早期PD患者。我们使用帕金森病自主神经功能障碍结局量表问卷来确定自主神经症状的患病率和频率。该队列被分为自主神经功能障碍评分高和低两组。回归模型确定了在我们的早期PD队列中独立解释自主神经功能障碍评分的变量。
414例PD患者诊断时的平均年龄为61.1（标准差9.7）岁，平均病程为6.7（标准差6.6）个月。在所有患者中，43.7%（181/414）的自主神经功能障碍评分高。泌尿和胃肠道症状是最普遍且最常报告的自主神经症状。有疲劳（β=4.28，P<0.001）、可能的快速眼动睡眠行为障碍（β=2.71，P<0.001）、日间过度嗜睡（β=1.88，P=0.039）、冲动和强迫行为（β=2.42，P<0.001）以及年龄增长（β=1.05，P<0.001）的患者更有可能自主神经功能障碍评分高。
早期PD患者下尿路和胃肠道症状普遍且频繁。疲劳、睡眠障碍、冲动和强迫行为以及年龄是自主神经功能障碍的预测因素。在这组早期PD患者的病程中，自主神经症状占主导，且与病情更严重相关。
