Shalash Ali S, Hamid Eman, Elrassas Hanan, Bahbah Eshak I, Mansour Alia H, Mohamed Hadeer, Elbalkimy Mahmoud
Faculty of Medicine, Department of Neurology, Ain Shams University, Cairo, Egypt.
Okasha Institute of Psychiatry, Ain Shams University, Cairo, Egypt.
PLoS One. 2021 Jan 27;16(1):e0245918. doi: 10.1371/journal.pone.0245918. eCollection 2021.
To compare non-motor symptoms (NMSs) among patients with essential tremor (ET), Parkinson's disease (PD) subtypes (akinetic-rigid type (ART) and tremor-dominant type (TDT)), and healthy controls.
This retrospective study included 129 participants, 72 PD (33 PD-ART, 33 PD-TDT, and 6 Mixed), 29 ET patients, and 28 controls. PD patients were assessed by the unified Parkinson's disease rating scale (UPDRS), Hoehn, and Yahr scale (H&Y), while ET patients were evaluated by the Fahn Tolosa Marin Tremor Rating Scale. All subjects were evaluated by non-motor symptoms scale (NMSS) for NMSs and Beck depression inventory (BDI) for depression.
PD subtypes groups, ET, and controls were age and gender-matched. Compared to controls, all PD, PD subtypes, and ET showed significantly worse most of NMSs (p<0.001) and depression. Compared to ET, all PD and PD-ART had significantly worse gastrointestinal (p = 0.002), urinary symptoms (p = 0.001, p = 0.003) and depression (p = 0.002) and PD-TDT worse depression, while ET patients showed worse memory/attention than PD subtypes. Total NMSS of ET is highly correlated to depression and moderately to tremor severity and age of onset, while total of NMSS is highly correlated to depression, disease severity, and disability.
The current study demonstrated several comparable domains of NMSs of PD subtypes and ET, except worse gastrointestinal and urinary symptoms among PD-ART. Identifying different NMSs profiles is important for predicting, better assessing, and tailoring management of ET and PD subtypes.
比较特发性震颤(ET)患者、帕金森病(PD)各亚型(少动强直型(ART)和震颤为主型(TDT))患者以及健康对照者的非运动症状(NMSs)。
这项回顾性研究纳入了129名参与者,其中72名PD患者(33名PD-ART、33名PD-TDT和6名混合型)、29名ET患者和28名对照者。PD患者通过统一帕金森病评定量表(UPDRS)、霍恩和雅尔量表(H&Y)进行评估,而ET患者通过法恩-托洛萨-马林震颤评定量表进行评估。所有受试者均通过非运动症状量表(NMSS)评估NMSs,并通过贝克抑郁量表(BDI)评估抑郁情况。
PD各亚型组、ET组和对照组在年龄和性别上相匹配。与对照组相比,所有PD患者、PD各亚型患者和ET患者的大多数NMSs(p<0.001)和抑郁情况均明显更严重。与ET患者相比,所有PD患者和PD-ART患者的胃肠道症状(p = 0.002)、泌尿系统症状(p = 0.001,p = 0.003)和抑郁情况(p = 0.002)明显更严重,PD-TDT患者的抑郁情况更严重,而ET患者的记忆/注意力比PD各亚型患者更差。ET患者的NMSS总分与抑郁高度相关,与震颤严重程度和发病年龄中度相关,而NMSS总分与抑郁、疾病严重程度和残疾高度相关。
当前研究表明,PD各亚型和ET的NMSs在几个方面具有可比性,但PD-ART患者的胃肠道和泌尿系统症状更严重。识别不同的NMSs特征对于预测、更好地评估和针对性管理ET和PD各亚型很重要。