Center for Parkinson's Disease and Movement Disorders, Department of Neurology, Vikram Hospital, Bangalore, Karnataka, India.
Parkinson and Ageing Research Foundation, Bangalore, Karnataka, India.
Can J Neurol Sci. 2022 Jan;49(1):93-101. doi: 10.1017/cjn.2021.40. Epub 2021 Mar 9.
To determine the demographic pattern of juvenile-onset parkinsonism (JP, <20 years), young-onset (YOPD, 20-40 years), and early onset (EOPD, 40-50 years) Parkinson's disease (PD) in India.
We conducted a 2-year, pan-India, multicenter collaborative study to analyze clinical patterns of JP, YOPD, and EOPD. All patients under follow-up of movement disorders specialists and meeting United Kingdom (UK) Brain Bank criteria for PD were included.
A total of 668 subjects (M:F 455:213) were recruited with a mean age at onset of 38.7 ± 8.1 years. The mean duration of symptoms at the time of study was 8 ± 6 years. Fifteen percent had a family history of PD and 13% had consanguinity. JP had the highest consanguinity rate (53%). YOPD and JP cases had a higher prevalence of consanguinity, dystonia, and gait and balance issues compared to those with EOPD. In relation to nonmotor symptoms, panic attacks and depression were more common in YOPD and sleep-related issues more common in EOPD subjects. Overall, dyskinesias were documented in 32.8%. YOPD subjects had a higher frequency of dyskinesia than EOPD subjects (39.9% vs. 25.5%), but they were first noted later in the disease course (5.7 vs. 4.4 years).
This large cohort shows differing clinical patterns in JP, YOPD, and EOPD cases. We propose that cutoffs of <20, <40, and <50 years should preferably be used to define JP, YOPD, and EOPD.
确定印度青少年发病帕金森病（JP，<20 岁）、年轻发病（YOPD，20-40 岁）和早发（EOPD，40-50 岁）帕金森病（PD）的人口统计学模式。
我们进行了一项为期 2 年的全印多中心合作研究，以分析 JP、YOPD 和 EOPD 的临床模式。所有符合英国（UK）脑库 PD 诊断标准并正在接受运动障碍专家随访的患者均纳入研究。
共招募了 668 名患者（男/女：455/213），发病年龄的平均值为 38.7±8.1 岁。研究时的平均症状持续时间为 8±6 年。15%的患者有 PD 家族史，13%有近亲结婚。JP 的近亲结婚率最高（53%）。与 EOPD 相比，YOPD 和 JP 患者的近亲结婚、肌张力障碍和步态及平衡问题更为常见。在非运动症状方面，YOPD 患者更易出现惊恐发作和抑郁，EOPD 患者更易出现睡眠相关问题。总体而言，32.8%的患者存在运动障碍。与 EOPD 患者相比，YOPD 患者运动障碍的发生率更高（39.9%比 25.5%），但在病程中出现的时间较晚（5.7 年比 4.4 年）。
本大规模队列研究显示 JP、YOPD 和 EOPD 患者的临床模式存在差异。我们建议，<20 岁、<40 岁和<50 岁的截止值更适合用来定义 JP、YOPD 和 EOPD。
