Aamodt Whitley W, Dubroff Jacob G, Cheng Gang, Taylor Betty, Wood Stephanie, Duda John E, Morley James F
Parkinson's Disease Research, Education, and Clinical Center, Corporal Michael J. Crescenz VA Medical Center, 3900 Woodland Avenue, Philadelphia, PA, 19104, USA.
Department of Neurology, University of Pennsylvania Perelman School of Medicine, 3W Gates, 3400 Spruce Street, Philadelphia, PA, 19104, USA.
NPJ Parkinsons Dis. 2022 Apr 28;8(1):53. doi: 10.1038/s41531-022-00309-8.
Drug-induced parkinsonism (DIP) can be clinically indistinguishable from degenerative parkinsonism, and bedside assessments are needed to differentiate between these conditions. We examined 34 U.S. Veterans with DIP using I-FP-CIT (DAT-SPECT) to identify underlying nigrostriatal degeneration. Participants were 94% male with mean age of 64.5 ± 7.1 years. DAT-SPECT was abnormal in 12/34 (35%). Comparing normal and abnormal imaging groups, there were no differences in age, sex, race/ethnicity, psychiatric diagnosis, motor severity, or RBD Screening Questionnaire scores. Those with underlying neurodegeneration reported significantly more non-motor symptoms (NMS), worse olfactory function on the University of Pennsylvania Smell Identification Test, and greater turning duration/steps on the instrumented Timed Up and Go. Area under the curve (AUC) combining poor olfaction and total NMS burden was 0.84 (CI 0.71-0.97), while AUC for turn steps was 0.91 (CI 0.81-1.00). Gait impairment, hyposmia, and NMS may be useful alone and in combination to identify DIP patients with underlying dopaminergic degeneration.
药物性帕金森综合征（DIP）在临床上可能与退行性帕金森病难以区分，因此需要床边评估来鉴别这些情况。我们使用I-FP-CIT（DAT-SPECT）对34名患有DIP的美国退伍军人进行了检查，以确定潜在的黑质纹状体变性。参与者中94%为男性，平均年龄为64.5±7.1岁。12/34（35%）的DAT-SPECT检查结果异常。比较正常和异常影像组，在年龄、性别、种族/民族、精神诊断、运动严重程度或快速动眼期行为障碍筛查问卷得分方面没有差异。存在潜在神经变性的患者报告的非运动症状（NMS）明显更多，在宾夕法尼亚大学嗅觉识别测试中的嗅觉功能更差，在仪器化计时起立行走测试中的转身持续时间/步数更多。结合嗅觉减退和总NMS负担的曲线下面积（AUC）为0.84（95%置信区间0.71-0.97），而转身步数的AUC为0.91（95%置信区间0.81-1.00）。步态障碍、嗅觉减退和NMS单独或联合使用可能有助于识别患有潜在多巴胺能变性的DIP患者。
