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帕金森病患者冻结步态的临床特征及相关因素。

Clinical features and related factors of freezing of gait in patients with Parkinson's disease.

机构信息

School of Clinical Medicine, Ningxia Medical University, Yinchuan, China.

Department of Neurology, General Hospital of Ningxia Medical University, Ningxia Key Laboratory of Cerebrocranial Diseases, Incubation Base of National Key Laboratory, Yinchuan, China.

出版信息

Brain Behav. 2021 Nov;11(11):e2359. doi: 10.1002/brb3.2359. Epub 2021 Sep 22.

Abstract

BACKGROUND

Freezing of gait (FOG) is a disabling paroxysmal gait disorder that prevents starting or resuming walking, which seriously negatively affects patients' quality of life (QOL). The diagnosis and treatment of FOG remain a huge medical challenge. The purpose of this study was to explore the clinical characteristics and related factors of FOG in patients with Parkinson's disease (PD).

METHODS

The motor and nonmotor symptoms of a total number of 77 PD patients were evaluated. Patients with or without FOG were defined as a score ≥1 in the new freezing of gait questionnaire (NFOG-Q). A comparative study between patients with and without FOG was conducted.

RESULTS

In this investigation, the prevalence of FOG was 48%. The patients with FOG had longer disease duration, higher Hoehn-Yahr stage (H-Y stage), higher dose of dopaminergic agents, and higher nonmotor and motor symptom scores. A significant positive correlation was found between the NFOG-Q score and the H-Y stage, PIGD subscore, PDQ-39, and the attention/memory in the nonmotor symptoms assessment scale (NMSS) subitem (r > 0.5, p < .05). The binary logistic regression analysis showed that the higher H-Y stage, higher rigidity subscore and Unified Parkinson's Disease Rating Scale II (UPDRS II) score, and UPDRS III score were significantly correlated with the occurrence of FOG (p < .05). In the analysis of the frequency of FOG, the prevalence of FOG in H-Y stage was higher in the middle and late stages, and the prevalence of FOG increased with the increase in PDQ-39 scores.

CONCLUSION

The severity of FOG was significantly positively correlated with the H-Y stage, PIGD subscore, PDQ-39 score, and attention/memory score. Based on our findings, we conclude that the clinical characteristics of rigidity can be used as a potential predictor of FOG.

摘要

背景

冻结步态(FOG)是一种致残性阵发性步态障碍,会妨碍起始或恢复行走,严重降低患者的生活质量(QOL)。FOG 的诊断和治疗仍然是一个巨大的医学挑战。本研究旨在探讨帕金森病(PD)患者 FOG 的临床特征及相关因素。

方法

评估了总共 77 名 PD 患者的运动和非运动症状。FOG 患者的定义为新冻结步态问卷(NFOG-Q)评分≥1。对有和无 FOG 的患者进行了比较研究。

结果

本研究中 FOG 的患病率为 48%。有 FOG 的患者疾病持续时间更长,Hoehn-Yahr 分期(H-Y 分期)更高,多巴胺能药物剂量更高,非运动和运动症状评分更高。NFOG-Q 评分与 H-Y 分期、PIGD 子评分、PDQ-39 和非运动症状评估量表(NMSS)注意力/记忆力子项呈显著正相关(r>0.5,p<.05)。二元逻辑回归分析显示,较高的 H-Y 分期、较高的僵硬子评分和统一帕金森病评定量表 II(UPDRS II)评分以及 UPDRS III 评分与 FOG 的发生显著相关(p<.05)。在 FOG 频率分析中,H-Y 分期中 FOG 的患病率在中晚期较高,且随着 PDQ-39 评分的增加,FOG 的患病率也随之增加。

结论

FOG 的严重程度与 H-Y 分期、PIGD 子评分、PDQ-39 评分和注意力/记忆力评分呈显著正相关。根据我们的发现,我们得出结论,僵硬的临床特征可以作为 FOG 的潜在预测指标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58e4/8613420/3c6f7e72ae33/BRB3-11-e2359-g002.jpg

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