Zhang Yu, Zhang Guo Yong, Zhu Xiao Bo, Zhang Zi En, Gan Jing, Liu Zhen Guo
Department of Neurology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Front Aging Neurosci. 2022 Jan 20;13:723405. doi: 10.3389/fnagi.2021.723405. eCollection 2021.
Psychotic symptoms are common in Parkinson's disease (PD). However, the clinical characteristics of PD psychosis (PDP) have been rarely reported in Chinese PD patients. We aimed to categorize PDP in a PD cohort and its relationship to other clinical characteristics.
A total of 149 Chinese PD patients were consecutively enrolled, and idiopathic PD patients were recruited in the study. The symptoms of PDP were assessed with the enhanced Scale for the Assessment of Positive Symptoms in PD. Then, the patients were classified into a PD-control group, isolated minor hallucination (MH) group, and complex MH group, and clinical and demographic data of different groups were compared.
Parkinson's disease psychosis was present in 40.3% (60/149) of our patients. The most common PDPs were MHs, present in 32.9% (49 of 149) of the cohort. Compared to patients without MHs, patients with MHs were older, had a longer disease duration, a higher levodopa equivalent daily dose, more severe motor symptoms, dyskinesia, a higher rate of rapid eye movement sleep behavior disorders, frontal lobe function impairments, and a higher percentage of cognitive impairment. Logistic regression analysis showed that advanced Hoehn-Yahr stage [odds ratio (OR): 2.697, = 0.007)] and frontal lobe function impairment (OR: 0.684, = 0.003) were independent risk factors for MHs.
MHs were frequent non-motor symptoms in PD patients. It was associated with increased motor and non-motor symptom burdens and reduced quality of life. MHs have been called "minor," but they have major clinical and prognostic implications and need early screening.
精神病性症状在帕金森病（PD）中很常见。然而，中国PD患者中帕金森病精神病（PDP）的临床特征鲜有报道。我们旨在对一组PD患者中的PDP进行分类，并探讨其与其他临床特征的关系。
连续纳入149例中国PD患者，均为特发性PD患者。采用改良的PD阳性症状评估量表对PDP症状进行评估。然后，将患者分为PD对照组、单纯轻度幻觉（MH）组和复杂MH组，并比较不同组的临床和人口统计学数据。
我们的患者中40.3%（60/149）存在帕金森病精神病。最常见的PDP是MH，在队列中的发生率为32.9%（149例中的49例）。与无MH的患者相比，有MH的患者年龄更大、病程更长、左旋多巴等效日剂量更高、运动症状更严重、有异动症、快速眼动睡眠行为障碍发生率更高、额叶功能受损，且认知障碍百分比更高。逻辑回归分析显示，较高的Hoehn-Yahr分期[比值比（OR）：2.697，P = 0.007]和额叶功能受损（OR：0.684，P = 0.003）是MH的独立危险因素。
MH是PD患者常见的非运动症状。它与运动和非运动症状负担增加及生活质量下降相关。MH虽被称为“轻度”，但具有重要的临床和预后意义，需要早期筛查。
