1st Department of Neurology, Medical School, National and Kapodistrian University of Athens, Eginition Hospital, 11528 Athens, Greece.
Medicina (Kaunas). 2023 Feb 5;59(2):294. doi: 10.3390/medicina59020294.
: So far, there is little evidence of the ambient effect on motor and non-motor symptoms of Parkinson's Disease (PD). This systematic review aimed to determine the association between ambiental factors and the progression of PD. A systematic literature search of PubMed, Cochrane, Embase, and Web of Science was conducted up to 21 December 2021 according the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. : Eight articles were used in the analyses. Long-term exposure to fine particles (particulate matter ≤ 2.5 μm; PM) was positively associated with disease aggravation in two studies. Short-term PM exposure was positively associated with disease aggravation in three studies. Significant associations were found between PD aggravation and NO, SO, CO, nitrate and organic matter (OM) concentrations in two studies. Associations were more pronounced, without reaching statistical significance however, in women, patients over 65 years old and cold temperatures. A 1% increase in temperature was associated with a significant 0.18% increase in Levodopa Equivalent Dose (LED). Ultraviolet light and humidity were not significantly associated with an increase in LED. There was no difference in hallucination severity with changing seasons. There was no evidence for seasonal fluctuation in Unified Parkinson's Disease Rating Scale (UPDRS) scores. : There is a link between air pollutants and temperature for PD progression, but this has yet to be proven. More longitudinal studies are warranted to confirm these findings.
到目前为止，关于环境因素对帕金森病（PD）的运动和非运动症状的影响，证据很少。本系统评价旨在确定环境因素与 PD 进展之间的关系。根据系统评价和荟萃分析的首选报告项目（PRISMA）指南，对 PubMed、Cochrane、Embase 和 Web of Science 进行了系统文献检索，检索时间截至 2021 年 12 月 21 日。
有 8 篇文章用于分析。两项研究表明，长期暴露于细颗粒物（颗粒物≤2.5μm；PM）与疾病加重呈正相关。三项研究表明，短期 PM 暴露与疾病加重呈正相关。两项研究表明，PD 加重与 NO、SO、CO、硝酸盐和有机物（OM）浓度之间存在显著关联。然而，在女性、65 岁以上的患者和寒冷的温度下，这些关联更为明显，但没有达到统计学意义。温度每升高 1%，左旋多巴等效剂量（LED）就会显著增加 0.18%。紫外线和湿度与 LED 的增加没有显著关联。幻觉严重程度随季节变化没有差异。统一帕金森病评定量表（UPDRS）评分没有季节性波动的证据。
空气污染和温度与 PD 进展之间存在关联，但这尚未得到证实。需要更多的纵向研究来证实这些发现。
