Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, Nebraska, USA.
Faculty of Medicine, Al-Azhar University, Damietta, Egypt.
Mov Disord. 2021 Mar;36(3):570-580. doi: 10.1002/mds.28412. Epub 2020 Dec 9.
Parkinson's disease (PD) is a chronic neurodegenerative disorder that presents with motor and non-motor manifestations. Amongst the non-motor features, various forms of sleep disturbances can occur, and obstructive sleep apnea (OSA) is considered to be a common comorbidity. We conducted this systematic review and meta-analysis to assess the impact of OSA on cognitive and motor functions in PD.
The information sources of for this systematic review and meta-analysis were PubMed, SCOPUS, Web of Science, and ScienceDirect. Studies meeting the following criteria were included: (1) studies including idiopathic PD patients, (2) studies using polysomnography to categorize PD patients into PD with OSA and PD without OSA, and (3) studies with observational designs (case-control, cohort, or cross-sectional). Data analysis was performed using RevMan.
Our meta-analysis showed that OSA was associated with significantly lower scores of Montreal Cognitive Assessments (MoCA) (mean difference (MD) = -0.70, 95% confidence interval (CI) [-1.28, -0.13], P = 0.01) and Mini-Mental State Examination (MMSE) (MD = -0.69, 95% CI [-1.17, -0.21], P = 0.005). Moreover, the score of the motor part of the Unified Parkinson's Disease Rating Scale (UPDRS III) was significantly higher in PD patients with OSA as compared with those without OSA (MD = 1.63, 95% CI [0.03, 3.23], P = 0.049).
OSA is associated with increased severity of PD-associated cognitive dysfunction and motor symptoms. However, further studies are needed to corroborate these findings, assess the underlying mechanisms by which OSA influences the motor and cognitive functions in PD, and investigate whether OSA can accelerate the neurodegenerative process of PD. © 2020 International Parkinson and Movement Disorder Society.
帕金森病（PD）是一种慢性神经退行性疾病，表现为运动和非运动症状。在非运动特征中，可能会出现各种形式的睡眠障碍，阻塞性睡眠呼吸暂停（OSA）被认为是一种常见的合并症。我们进行了这项系统评价和荟萃分析，以评估 OSA 对 PD 患者认知和运动功能的影响。
本系统评价和荟萃分析的信息来源为 PubMed、SCOPUS、Web of Science 和 ScienceDirect。符合以下标准的研究被纳入：（1）研究包括特发性 PD 患者；（2）研究使用多导睡眠图将 PD 患者分为 PD 合并 OSA 组和 PD 无 OSA 组；（3）研究设计为观察性设计（病例对照、队列或横断面）。使用 RevMan 进行数据分析。
我们的荟萃分析显示，OSA 与蒙特利尔认知评估（MoCA）评分显著降低相关（平均差异（MD）=-0.70，95%置信区间（CI）[-1.28，-0.13]，P=0.01）和简易精神状态检查（MMSE）（MD=-0.69，95%CI[-1.17，-0.21]，P=0.005）。此外，与无 OSA 的 PD 患者相比，OSA 患者的帕金森病统一评定量表（UPDRS III）的运动部分评分显著升高（MD=1.63，95%CI[0.03，3.23]，P=0.049）。
OSA 与 PD 相关认知功能障碍和运动症状的严重程度增加有关。然而，需要进一步的研究来证实这些发现，评估 OSA 影响 PD 患者运动和认知功能的潜在机制，并研究 OSA 是否会加速 PD 的神经退行性过程。© 2020 国际帕金森病和运动障碍学会。
