Department of Neurology, Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.
Sci Rep. 2020 Dec 10;10(1):21749. doi: 10.1038/s41598-020-78794-1.
This study aimed to explore the effect of pre-existing essential tremor (ET) history on the disease progression of Parkinson's disease (PD). We recruited and followed-up a group of PD patients from March 2009 to July 2020. The ET history of each patient was obtained by retrospective interviews or past medical records. Cox proportional hazards models with inverse probability of treatment weighting (IPTW) were used to estimate the hazard ratio (HR) with 95% confidence intervals (CIs). Of 785 patients who completed the followed-up visits, 61 patients (7.8%) reported a history of pre-existing ET. Cox regression models after IPTW indicated that the positive ET history in patients with PD was protective against time to United PD Rating Scale III 14-point increase (HR = 0.301, 95% CI = 0.134-0.678, P = 0.004), time to akinesia and rigidity 8-point increase (HR = 0.417, 95% CI = 0.218-0.796, P = 0.008), time to conversion to Hoehn and Yahr stage 3 (HR = 0.356, 95% CI = 0.131-0.969, P = 0.043), time to develop dyskinesia (HR = 0.160, 95% CI = 0.037-0.698, P = 0.015), and time to Montreal Cognitive Assessment 3-point decrease (HR = 0.389, 95% CI = 0.160-0.946, P = 0.037), but had no relationship with time to tremor 4-point increase (HR = 1.638, 95% CI = 0.822-3.266, P = 0.161) and time to death (HR = 0.713, 95% CI = 0.219-2.319, P = 0.574). Our study indicated that ET history in patients with PD is associated with a benign prognosis with slower motor and non-motor progression.
这项研究旨在探讨预先存在的特发性震颤（ET）病史对帕金森病（PD）疾病进展的影响。我们招募并随访了一组 2009 年 3 月至 2020 年 7 月的 PD 患者。每位患者的 ET 病史均通过回顾性访谈或既往病历获得。采用逆概率治疗加权（IPTW）的 Cox 比例风险模型来估计风险比（HR）及其 95%置信区间（CI）。在完成随访的 785 名患者中，有 61 名（7.8%）患者报告有预先存在的 ET 病史。经过 IPTW 的 Cox 回归模型表明，PD 患者的阳性 ET 病史对 United PD Rating Scale III 14 点增加的时间（HR=0.301，95%CI=0.134-0.678，P=0.004）、无运动不能和僵硬 8 点增加的时间（HR=0.417，95%CI=0.218-0.796，P=0.008）、向 Hoehn 和 Yahr 分期 3 期的转换时间（HR=0.356，95%CI=0.131-0.969，P=0.043）、发展为运动障碍的时间（HR=0.160，95%CI=0.037-0.698，P=0.015）和蒙特利尔认知评估量表 3 点下降的时间（HR=0.389，95%CI=0.160-0.946，P=0.037）具有保护作用，但与震颤 4 点增加的时间（HR=1.638，95%CI=0.822-3.266，P=0.161）和死亡时间（HR=0.713，95%CI=0.219-2.319，P=0.574）无关。我们的研究表明，PD 患者的 ET 病史与较慢的运动和非运动进展相关，预后较好。
