Department of Neurology, Yonsei University College of Medicine, Seoul,South Korea.
Department of Neurology, Yongin Severance Hospital, Yonsei University Health System, Yongin, South Korea.
J Gerontol A Biol Sci Med Sci. 2021 Nov 15;76(12):2242-2248. doi: 10.1093/gerona/glab082.
To investigate the relationship between temporalis muscle thickness (TMT) at baseline as a surrogate marker for sarcopenia and long-term motor outcomes in patients with Parkinson's disease (PD).
We enrolled 249 patients with drug-naïve early-stage PD (119 males and 130 females, follow-up > 3 years). Baseline TMT of each patient was measured on the axial plane of T1-weighted images. The association between baseline TMT and long-term motor outcomes in PD was assessed using Cox regression models for levodopa-induced dyskinesia, wearing-off, and freezing of gait and a linear mixed model for the longitudinal increases in levodopa-equivalent dose per body weight over time. Statistical analyses were performed separately for sex if an interaction effect between TMT and sex was assumed.
TMT differed substantially between the sexes, and male PD patients had higher TMT (6.69 ± 1.39 mm) than female PD patients (5.64 ± 1.34 mm, p < .001). Cox regression models demonstrated that baseline TMT was not associated with the risk of developing levodopa-induced dyskinesia, wearing-off, or freezing of gait during the follow-up period. The linear mixed model was applied separately for sex and demonstrated that higher TMT at baseline was associated with slower increases in levodopa-equivalent dose per body weight in male PD patients, but not in female PD patients.
This study demonstrated that baseline TMT could be an indicator of the longitudinal requirement for dopaminergic medications in male patients with PD, suggesting that sarcopenia may have a detrimental effect on disease progression in PD in a sex-specific manner.
本研究旨在探讨作为肌少症替代标志物的颞肌厚度（TMT）与帕金森病（PD）患者长期运动结局之间的关系。
我们纳入了 249 例初诊的、药物未治疗的早期 PD 患者（119 名男性，130 名女性，随访时间＞3 年）。使用 T1 加权图像的轴位对每位患者的基线 TMT 进行测量。使用 Cox 回归模型评估基线 TMT 与 PD 患者左旋多巴诱导的运动障碍、开-关现象和冻结步态之间的关系，使用线性混合模型评估随着时间推移，左旋多巴等效剂量/体重的纵向增加。如果假设 TMT 与性别之间存在交互效应，则对性别分别进行统计分析。
TMT 在性别之间存在显著差异，男性 PD 患者的 TMT（6.69±1.39mm）高于女性 PD 患者（5.64±1.34mm，p＜0.001）。Cox 回归模型表明，基线 TMT 与随访期间发生左旋多巴诱导的运动障碍、开-关现象或冻结步态的风险无关。线性混合模型分别按性别进行分析，结果表明，基线 TMT 较高与男性 PD 患者左旋多巴等效剂量/体重的增加速度较慢有关，但与女性 PD 患者无关。
本研究表明，基线 TMT 可能是男性 PD 患者长期使用多巴胺能药物需求的指标，提示肌少症可能以性别特异性的方式对 PD 的疾病进展产生不利影响。
