Wang Jing, Cao Ruihua, Huang Tao, Liu Cheng, Fan Yidong
Department of Urology, Qilu Hospital, Cheeloo College of Meicine, Shandong University, Jinan, China.
Department of Urologic Oncology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.
Parkinsons Dis. 2020 Nov 28;2020:4981647. doi: 10.1155/2020/4981647. eCollection 2020.
The aim of the present study was to determine the relation between urinary dysfunction and nigrostriatal dopaminergic degeneration in early and untreated Parkinson's disease (PD). The data were obtained from Parkinson's Progression Markers Initiative database. Two hundred and seventy-five patients and 149 healthy controls were included in our analysis. Urinary symptoms were evaluated with the Scale for Outcomes in Parkinson's Disease for Autonomic Symptoms (SCOPA-AUT). We performed correlation analyses between I-FP-CIT SPECT imaging data and severity of urinary symptoms in patients with PD and healthy controls. Early and untreated patients with PD exhibited worse urinary symptoms when compared with healthy controls. The severity of urinary symptoms significantly correlated with dopamine transporter binding levels in the caudate and the putamen. After controlling for age and sex, the severity of storage symptoms significantly correlated with dopamine transporter binding levels in the less affected side of the putamen ( = -0.172, =0.004). The correlation was observed in both male ( = -0.152, =0.043) and female patients ( = -0.217, =0.034). No correlations were found between dopamine transporter binding levels and voiding symptoms in male or female patients, or any urinary symptoms in healthy controls. Worse storage symptoms reflect greater nigrostriatal dopaminergic loss in early and untreated PD.
本研究的目的是确定早期未经治疗的帕金森病(PD)患者的排尿功能障碍与黑质纹状体多巴胺能变性之间的关系。数据来自帕金森病进展标志物倡议数据库。我们的分析纳入了275例患者和149名健康对照。使用帕金森病自主神经症状结局量表(SCOPA-AUT)评估排尿症状。我们对PD患者和健康对照的I-FP-CIT SPECT成像数据与排尿症状严重程度进行了相关性分析。与健康对照相比,早期未经治疗的PD患者表现出更严重的排尿症状。排尿症状的严重程度与尾状核和壳核中的多巴胺转运体结合水平显著相关。在控制年龄和性别后,储尿症状的严重程度与壳核受累较轻一侧的多巴胺转运体结合水平显著相关(r = -0.172,P = 0.004)。在男性(r = -0.152,P = 0.043)和女性患者(r = -0.217,P = 0.034)中均观察到这种相关性。在男性或女性患者中,未发现多巴胺转运体结合水平与排尿症状之间存在相关性,在健康对照中也未发现与任何排尿症状存在相关性。更严重的储尿症状反映了早期未经治疗的PD患者黑质纹状体多巴胺能损失更大。