Department of Neurosciences and Reproductive and Odontostomatological Sciences, Federico II University, Via Pansini 5, 80131, Naples, Italy.
Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Mondino Foundation, Pavia, Italy.
Acta Neurol Belg. 2023 Feb;123(1):221-226. doi: 10.1007/s13760-022-02165-y. Epub 2023 Jan 7.
Mutations of the Glucocerebrosidase (GBA) gene are the most common genetic risk factor yet discovered for Parkinson's Disease (PD), being found in about 5-14% of Caucasian patients.
We aimed to assess motor and non-motor symptoms (NMS) in patients with GBA-related PD (GBA-PD) in comparison with idiopathic PD (iPD) subjects using standardized and validated scales.
Eleven (4 M, 7 F) patients with GBA-PD and 22 iPD patients, selected from the same cohort and matched for gender, age, and disease duration, were enrolled. The disease severity was assessed by Unified Parkinson's Disease Rating Scale-section III, gait disorder and falls by Freezing of Gait Questionnaire, and motor fluctuations by Wearing off questionnaire. NMS were evaluated using the following scales: Mini-Mental State Examination and extended neuropsychological battery, if required, Non-Motor Symptoms Scale, SCOPA-AUT Questionnaire, Apathy Evaluation Scale, Beck Depression Inventory, Epworth Sleepiness Scale, Restless Legs Syndrome Rating Scale, REM Sleep Behavior Disorder Screening Questionnaire, and Questionnaire for Impulsive-Compulsive Disorders in Parkinson's disease.
GBA-PD patients showed a more severe and rapidly progressive disease, and more frequent positive family history for PD, akinetic-rigid phenotype, postural instability, dementia, and psychosis in comparison to iPD. Two of three subjects carrying L444P mutation presented with early dementia. We also found a higher occurrence of fatigue, diurnal sleepiness, and intolerance to heat/cold in the carriers group.
Our results confirm that NMS and a more severe and faster disease course more frequently occur among GBA-PD patients in comparison to iPD.
葡萄糖脑苷脂酶(GBA)基因突变是迄今为止发现的帕金森病(PD)最常见的遗传风险因素,在 5-14%的白种人群中被发现。
我们旨在使用标准化和经过验证的量表评估 GBA 相关帕金森病(GBA-PD)患者的运动和非运动症状(NMS)与特发性帕金森病(iPD)患者的差异。
从同一队列中选择了 11 名(4 名男性,7 名女性)GBA-PD 患者和 22 名 iPD 患者,这些患者在性别、年龄和疾病持续时间上相匹配。使用统一帕金森病评定量表第 III 部分评估疾病严重程度,使用冻结步态问卷评估步态障碍和跌倒,使用药物诱发的运动障碍问卷评估运动波动。使用以下量表评估 NMS:简易精神状态检查和扩展神经心理学测试(如需要)、非运动症状量表、SCOPA-AUT 问卷、淡漠评估量表、贝克抑郁量表、Epworth 嗜睡量表、不安腿综合征严重程度量表、快速眼动睡眠行为障碍筛查问卷和帕金森病冲动-强迫障碍问卷。
与 iPD 患者相比,GBA-PD 患者的疾病更严重、进展更快,且阳性家族史、少动强直型表型、姿势不稳、痴呆和精神病更为常见。携带 L444P 突变的 3 名患者中有 2 名出现了早期痴呆。我们还发现,携带者组疲劳、白天嗜睡和对热/冷不耐受的发生率更高。
我们的研究结果证实,与 iPD 患者相比,GBA-PD 患者的 NMS 更多,且疾病更严重、进展更快。