Program of Neuroscience, Graduate School of Health Sciences, Istanbul Medipol University, Istanbul, Turkey.
Program of Electroneurophysiology, Vocational School, Istanbul Medipol University, Istanbul, Turkey.
Ir J Med Sci. 2021 Nov;190(4):1577-1584. doi: 10.1007/s11845-020-02462-6. Epub 2021 Jan 15.
Parkinson's disease (PD) is characterized by non-motor symptoms (NMS) as well as by motor symptoms. Together with the impairment of cognitive functions, NMS and sleep also affect motor symptoms negatively. The aim of our study is to examine the correlation of NMS and sleep on balance in PD patients with normal cognition (PD-NC) and with mild cognitive impairment (PD-MCI).
A total of 69 patients were included in our study. Using the Standardized Mini-Mental State Examination, participants were divided into 2 groups, PD-NC and PD-MCI. Patients were assessed with the Unified Parkinson's Disease Rating Scale (UPDRS), the Berg Balance Scale (BBS), the Tinetti Balance Assessment Tool (TBAT), the Non-Motor Symptoms Questionnaire (NMSQ), and the Parkinson's Disease Questionnaire (PDQ-39).
PD-MCI patients had statistically significant worse motor symptoms and more balance disorder compared to PD-NC (UPDRS: p = 0.009; BBS: p = 0.010; TBAT: p = 0.004). PD-MCI patients had greater severity of non-motor symptoms and worse sleep quality than the PD-NC group (NMSQ-total: p = 0.02; NMSQ-sleep total: p = 0.01). The evaluation has shown that with a diagnosis of MCI, NMS, and sleeping problems were correlated, and the correlation was associated with impairment of the balance function. While being more pronounced in the PD-MCI group, quality of life was affected in both groups (p < 0.05).
Our data demonstrate a negative effect on the balance function in patients with cognitive impairment suffering increased NMS and sleeping disorders. Treatment of these patients needs to concentrate on NMS and cognitive functions as much as on motor symptoms.
帕金森病（PD）的特征是存在运动症状和非运动症状（NMS）。除了认知功能受损外，NMS 和睡眠问题也会对运动症状产生负面影响。我们的研究旨在检查认知正常（PD-NC）和轻度认知障碍（PD-MCI）的 PD 患者的 NMS 和睡眠对平衡的影响。
本研究共纳入 69 例患者。使用标准化简易精神状态检查表，将参与者分为 2 组，即 PD-NC 和 PD-MCI。采用统一帕金森病评定量表（UPDRS）、伯格平衡量表（BBS）、蒂内蒂平衡评估量表（TBAT）、非运动症状问卷（NMSQ）和帕金森病问卷（PDQ-39）对患者进行评估。
与 PD-NC 相比，PD-MCI 患者的运动症状明显更差，平衡障碍更严重（UPDRS：p=0.009；BBS：p=0.010；TBAT：p=0.004）。PD-MCI 患者的非运动症状更严重，睡眠质量更差（NMSQ 总分：p=0.02；NMSQ 睡眠总分：p=0.01）。评估结果表明，随着 MCI 的诊断，NMS 和睡眠问题存在相关性，且这种相关性与平衡功能障碍有关。尽管在 PD-MCI 组中更为明显，但两组患者的生活质量都受到影响（p<0.05）。
我们的数据表明，认知障碍患者的 NMS 和睡眠障碍会对平衡功能产生负面影响。治疗这些患者需要集中精力治疗 NMS 和认知功能，以及运动症状。
