Riboldi Giulietta Maria, Russo Marco J, Pan Ling, Watkins Kristen, Kang Un Jung
Department of Neurology, the Marlene and Paolo Fresco Institute for Parkinson's Disease and Movement Disorders, New York University Langone Health, New York, NY, 10017, USA.
NYU Langone Neurosurgery Associates, New York, NY, 10016, USA.
NPJ Parkinsons Dis. 2022 Aug 30;8(1):110. doi: 10.1038/s41531-022-00373-0.
Non-motor symptoms of Parkinson's disease (PD) such as dysautonomia and REM sleep behavior disorder (RBD) are recognized to be important prodromal symptoms that may also indicate clinical subtypes of PD with different pathogenesis. Unbiased clustering analyses showed that subjects with dysautonomia and RBD symptoms, as well as early cognitive dysfunction, have faster progression of the disease. Through analysis of the Parkinson's Progression Markers Initiative (PPMI) de novo PD cohort, we tested the hypothesis that symptoms of dysautonomia and RBD, which are readily assessed by standard questionnaires in an ambulatory care setting, may help to independently prognosticate disease progression. Although these two symptoms associate closely, dysautonomia symptoms predict severe progression of motor and non-motor symptoms better than RBD symptoms across the 3-year follow-up period. Autonomic system involvement has not received as much attention and may be important to consider for stratification of subjects for clinical trials and for counseling patients.
帕金森病（PD）的非运动症状，如自主神经功能障碍和快速眼动睡眠行为障碍（RBD），被认为是重要的前驱症状，也可能提示具有不同发病机制的PD临床亚型。无偏聚类分析表明，有自主神经功能障碍和RBD症状以及早期认知功能障碍的受试者疾病进展更快。通过对帕金森病进展标志物计划（PPMI）新发PD队列的分析，我们检验了以下假设：在门诊护理环境中可通过标准问卷轻松评估的自主神经功能障碍和RBD症状，可能有助于独立预测疾病进展。尽管这两种症状密切相关，但在3年随访期内，自主神经功能障碍症状比RBD症状更能预测运动和非运动症状的严重进展。自主神经系统受累尚未得到足够关注，对于临床试验受试者分层和为患者提供咨询而言，可能有必要加以考虑。
