Skidmore Frank M, Monroe William S, Hurt Christopher P, Nicholas Anthony P, Gerstenecker Adam, Anthony Thomas, Jololian Leon, Cutter Gary, Bashir Adil, Denny Thomas, Standaert David, Disbrow Elizabeth A
Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA.
Department of Electrical & Computer Engineering, University of Alabama at Birmingham, Birmingham, AL, USA.
NPJ Parkinsons Dis. 2022 Mar 18;8(1):28. doi: 10.1038/s41531-022-00287-x.
Identification of individuals at high risk for rapid progression of motor and cognitive signs in Parkinson disease (PD) is clinically significant. Postural instability and gait dysfunction (PIGD) are associated with greater motor and cognitive deterioration. We examined the relationship between baseline clinical factors and the development of postural instability using 5-year longitudinal de-novo idiopathic data (n = 301) from the Parkinson's Progressive Markers Initiative (PPMI). Logistic regression analysis revealed baseline features associated with future postural instability, and we designated this cohort the emerging postural instability (ePI) phenotype. We evaluated the resulting ePI phenotype rating scale validity in two held-out populations which showed a significantly higher risk of postural instability. Emerging PI phenotype was identified before onset of postural instability in 289 of 301 paired comparisons, with a median progression time of 972 days. Baseline cognitive performance was similar but declined more rapidly in ePI phenotype. We provide an ePI phenotype rating scale (ePIRS) for evaluation of individual risk at baseline for progression to postural instability.
识别帕金森病（PD）中运动和认知症状快速进展的高危个体具有临床意义。姿势不稳和步态功能障碍（PIGD）与更严重的运动和认知衰退相关。我们使用帕金森病进展标记物倡议（PPMI）的5年纵向新发特发性数据（n = 301），研究了基线临床因素与姿势不稳发展之间的关系。逻辑回归分析揭示了与未来姿势不稳相关的基线特征，我们将这一队列定义为新兴姿势不稳（ePI）表型。我们在另外两个独立人群中评估了所得ePI表型评定量表的有效性，这两个人群显示出姿势不稳的风险显著更高。在301对配对比较中，有289对在姿势不稳发作前就识别出了新兴PI表型，中位进展时间为972天。基线认知表现相似，但ePI表型下降得更快。我们提供了一种ePI表型评定量表（ePIRS），用于评估个体在基线时进展为姿势不稳的风险。
