Department of Medical and Surgical Specialties and Dentistry, University of Campania "Luigi Vanvitelli", Naples, Italy.
Department of Mental and Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy.
NeuroRehabilitation. 2021;49(3):481-489. doi: 10.3233/NRE-210146.
In patients with Parkinson disease (PD), severe postural and gait impairments are rarely observed in early stage of disease and non-motor symptoms (NMS) are often overlooked.
This observational study aimed to characterize the impact of non-motor impairments on walking kinematics in early stages PD patients, and to assess the differences of gait parameters and NMS between PD patients with and without mild cognitive impairment (MCI).
Twenty-six patients with Modified Hoehn and Yahr Scale score≤2 were evaluated for NMS using Kings Parkinson's Pain Scale, Parkinson Fatigue Severity scale, Parkinson Anxiety Scale, Beck Depression Inventory and Epworth Sleepiness Scale, kinematic parameters through an inertial sensor and cognitive performance by a comprehensive neuropsychological battery.
Fatigue had a moderate negative correlation with step cadence, and a moderate to strong positive correlation with gait duration, Timed Up and Go (TUG) and TUG Dual Task (p < 0.01). Pain showed positive moderate correlation with gait duration (p < 0.01). Twelve patients resulted affected by MCI and reported significantly worse scores in gait duration, pain and fatigue (p < 0.05). According to cognitive z scores, PD-MCI group showed a moderate negative correlation between visuospatial abilities and fatigue (p < 0.05).
NMS significantly affect walking kinematics whereas a limited role of cognitive status on motor performance occur in the early PD stages.
在帕金森病（PD）患者中，严重的姿势和步态障碍在疾病早期很少观察到，而非运动症状（NMS）往往被忽视。
本观察性研究旨在探讨非运动障碍对早期 PD 患者行走运动学的影响，并评估伴有和不伴有轻度认知障碍（MCI）的 PD 患者在步态参数和 NMS 方面的差异。
使用 Kings Parkinson 疼痛量表、帕金森疲劳严重程度量表、帕金森焦虑量表、贝克抑郁量表和 Epworth 嗜睡量表评估 26 例改良 Hoehn 和 Yahr 量表评分≤2 的患者的 NMS，使用惯性传感器评估运动学参数，并通过综合神经心理学测试评估认知表现。
疲劳与步频呈中度负相关，与步态持续时间、计时起立行走测试（TUG）和 TUG 双重任务呈中度到强正相关（p<0.01）。疼痛与步态持续时间呈正相关（p<0.01）。12 例患者患有 MCI，报告的步态持续时间、疼痛和疲劳评分明显较差（p<0.05）。根据认知 z 分数，PD-MCI 组的视觉空间能力与疲劳之间呈中度负相关（p<0.05）。
在早期 PD 阶段，NMS 显著影响行走运动学，而认知状态对运动表现的影响有限。
