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帕金森病患者携带 GBA 基因突变的运动和非运动特征。

Motor and non-motor features in Parkinson's Disease patients carrying GBA gene mutations.

机构信息

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.

出版信息

Acta Neurol Belg. 2023 Feb;123(1):221-226. doi: 10.1007/s13760-022-02165-y. Epub 2023 Jan 7.

Abstract

BACKGROUND

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.

OBJECTIVE

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.

METHODS

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.

RESULTS

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.

CONCLUSIONS

Our results confirm that NMS and a more severe and faster disease course more frequently occur among GBA-PD patients in comparison to iPD.

摘要

背景

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。

目的

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。

方法

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。

结果

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。

结论

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。

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