Kataoka Hiroshi, Sugie Kazuma
Department of Neurology, Nara Medical University, Kashihara, Nara 634-8522, Japan.
Neurol Int. 2021 May 26;13(2):224-231. doi: 10.3390/neurolint13020023.
The severity of Parkinson's disease (PD) is developed by multifactorial factors. Falls can worsen disease severity. We previously found that frontal assessment battery (FAB) score was associated with a higher risk of future falls. This eight-year follow-up study aimed to verify whether factors including low FAB score can be the risk of PD progression based on the Hoehn and Yahr scale. In total, 95 patients were initially enrolled in this research and 45 were included in the final follow-up. Then, the cohort was classified into patients with and without disease progression, defined by upgrade of Hoehn-Yahr stage. Differences in clinical characteristics between patients with disease progression and those without were evaluated using the Mann-Whitney U test. Eighteen independent variables were evaluated via a univariate logistic regression analysis. Of the 45 patients enrolled, 32 had disease progression and 13 had no progression. Age ( = 0.033), BFI score ( = 0.003), Zung self-rating depression ( = 0.011), and anxiety scale ( = 0.026) were significantly increased in patients who had disease progression than those with no disease progression. On multivariate logistic regression analysis, brief fatigue inventory (BFI) score (OR = 1.048, = 0.045, 95% CI = 1.001-1.098) was significantly related to disease progression. All BFI subscores related to general fatigue. Fatigue could predict the progression of motor dysfunction severity over a longitudinal duration in patients with PD with disease progression, having declining physical and mental fatigue.
帕金森病（PD）的严重程度由多种因素导致。跌倒会使疾病严重程度恶化。我们之前发现额叶评估量表（FAB）评分与未来更高的跌倒风险相关。这项为期八年的随访研究旨在验证包括低FAB评分在内的因素是否会基于Hoehn和Yahr量表成为PD进展的风险因素。总共95名患者最初参与了本研究，45名患者纳入最终随访。然后，根据Hoehn - Yahr分期的升级，将队列分为疾病进展组和无疾病进展组。使用Mann - Whitney U检验评估疾病进展组和无疾病进展组患者临床特征的差异。通过单因素逻辑回归分析评估18个自变量。在纳入的45名患者中，32名有疾病进展，13名无进展。有疾病进展的患者在年龄（ = 0.033）、BFI评分（ = 0.003）、Zung自评抑郁量表（ = 0.011）和焦虑量表（ = 0.026）方面显著高于无疾病进展的患者。在多因素逻辑回归分析中，简明疲劳量表（BFI）评分（OR = 1.048， = 0.045，95%CI = 1.001 - 1.098）与疾病进展显著相关。所有BFI子评分均与一般疲劳相关。疲劳可以预测疾病进展的PD患者在纵向病程中运动功能障碍严重程度的进展，其身心疲劳程度在下降。
