Buchanan Sarah M, Richards Marcus, Schott Jonathan M, Schrag Anette
Dementia Research Centre, University College London Institute of Neurology, University College London, London, United Kingdom.
Otago Medical School, University of Otago, Dunedin, New Zealand.
Mov Disord. 2021 Nov;36(11):2481-2493. doi: 10.1002/mds.28777. Epub 2021 Sep 25.
Mild parkinsonian signs (MPS) have been widely studied during the past 3 decades and proposed as a risk marker for neurodegenerative disease. This systematic review explores the epidemiology, clinical and prognostic associations, radiological features, and pathological findings associated with MPS in older adults free from neurodegenerative disease. We find that MPS as currently defined are strongly associated with increasing age and increased risk of development of Parkinson's disease (PD), all-cause dementia, disability, and death. Positive associations with later PD are found mainly in younger populations and those with other features of prodromal PD. There are currently no consistent radiological findings for MPS, and pathological studies have shown that MPS, at least in the oldest old, are often underpinned by mixed neuropathologies, including those associated with Alzheimer's disease, cerebrovascular disease, nigral neuronal loss, and Lewy bodies. Different subcategories of MPS appear to convey varying risk and specificity for PD and other outcomes. MPS overall are not specific for parkinsonian disorders and, although associated with increased risk of PD, can reflect multiple pathologies, particularly in older individuals. "Mild motor signs" appears a more appropriate term to avoid prognostic and pathological implications, and larger future studies to prospectively examine outcomes and associations of specific MPS subcategories are required. © 2021 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
在过去30年里，轻度帕金森体征（MPS）得到了广泛研究，并被提议作为神经退行性疾病的风险标志物。本系统评价探讨了无神经退行性疾病的老年人中与MPS相关的流行病学、临床和预后关联、放射学特征及病理发现。我们发现，目前所定义的MPS与年龄增长以及帕金森病（PD）、全因性痴呆、残疾和死亡风险增加密切相关。与晚期PD的正相关主要见于较年轻人群以及具有前驱PD其他特征的人群。目前MPS尚无一致的放射学表现，病理研究表明，MPS至少在高龄老人中常由多种神经病理学改变所支撑，包括与阿尔茨海默病、脑血管疾病、黑质神经元丢失和路易小体相关的改变。MPS的不同亚类似乎对PD和其他结局具有不同的风险和特异性。总体而言，MPS并非帕金森病性障碍所特有，尽管与PD风险增加相关，但可反映多种病理改变，尤其是在老年人中。“轻度运动体征”似乎是一个更合适的术语，以避免预后和病理方面的影响，未来需要开展更大规模的前瞻性研究，以检验特定MPS亚类的结局和关联。© 2021作者。《运动障碍》由Wiley Periodicals LLC代表国际帕金森和运动障碍协会出版。
