特发性震颤综合征患者异常串联步态的患病率及危险因素：中国西南地区的一项横断面研究
Prevalence and risk factors for abnormal tandem gait in patients with essential tremor syndrome: A cross-sectional study in Southwest China.
作者信息
Huang Hongyan, He Xianghua, Shen Qiuyan, Zhang Dan, Bao Yi, Xu Fang, Luo Anling, Liu Ling, Yang Xinglong, Xu Yanming
机构信息
Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Department of Neurology, Jiangbin Hospital, Nanning, Guangxi, China.
出版信息
Front Neurol. 2023 Feb 16;14:998205. doi: 10.3389/fneur.2023.998205. eCollection 2023.
OBJECTIVES
Patients with essential tremor (ET) syndrome have more prevalent and more serious gait and balance impairments than healthy controls. In this cross-sectional study, we explored whether balance impairments are associated with falls as well as more pronounced non-motor symptoms in patients with ET syndrome.
METHODS
We assessed the tandem gait (TG) test, as well as falls or near-falls that occurred over the previous year. Non-motor symptoms-including cognitive deficits, psychological and sleep disorders-were evaluated. In univariate analyses, statistical significance was corrected for multiple comparisons using the Benjamini-Hochberg method. Multiple logistic regression was utilized to evaluate the risk factors of poor TG performance in patients with ET syndrome.
RESULTS
A total of 358 patients with ET syndrome were divided into the abnormal TG (a-TG) and normal TG (n-TG) groups based on their performances in the TG test. We revealed that 47.2% of patients with ET syndrome had a-TG. The patients with a-TG were older, were more likely female, and were more likely present with cranial tremors and falls or near-falls (all adjusted < 0.01). The patients with a-TG had significantly lower Mini-Mental Status Examination scores, as well as significantly higher Hamilton Depression/Anxiety Rating Scale and Pittsburgh Sleep Quality Index scores. Multiple logistic regression analysis demonstrated that female sex (OR 1.913, 95% CI: 1.180-3.103), age (OR 1.050, 95% CI: 1.032-1.068), cranial tremor scores (OR 1.299, 95% CI: 1.095-1.542), a history of falls or near-falls (OR 2.952, 95% CI: 1.558-5.594), and the presence of depressive symptoms (OR 1.679, 95% CI: 1.034-2.726) were associated with the occurrence of a-TG in patients with ET syndrome.
CONCLUSION
TG abnormalities may be a predictor of fall risk in patients with ET syndrome and are associated with non-motor symptoms, especially depression.
目的
与健康对照相比，特发性震颤（ET）综合征患者存在更普遍、更严重的步态和平衡障碍。在这项横断面研究中，我们探讨了ET综合征患者的平衡障碍是否与跌倒以及更明显的非运动症状相关。
方法
我们评估了串联步态（TG）测试以及过去一年中发生的跌倒或险些跌倒情况。对包括认知缺陷、心理和睡眠障碍在内的非运动症状进行了评估。在单变量分析中，使用Benjamini-Hochberg方法对多重比较的统计显著性进行了校正。采用多因素逻辑回归分析评估ET综合征患者TG表现不佳的危险因素。
结果
根据TG测试表现，共358例ET综合征患者被分为异常TG（a-TG）组和正常TG（n-TG）组。我们发现，47.2%的ET综合征患者存在a-TG。a-TG患者年龄更大，女性比例更高，更易出现头部震颤以及跌倒或险些跌倒（所有校正P<0.01）。a-TG患者的简易精神状态检查表评分显著更低，汉密尔顿抑郁/焦虑评定量表评分和匹兹堡睡眠质量指数评分显著更高。多因素逻辑回归分析表明，女性（比值比1.913，95%置信区间：1.180-3.103）、年龄（比值比1.050，95%置信区间：1.032-1.068）、头部震颤评分（比值比1.299，95%置信区间：1.095-1.542）、跌倒或险些跌倒史（比值比2.952，95%置信区间：1.558-5.594）以及抑郁症状的存在（比值比1.679，95%置信区间：1.034-2.726）与ET综合征患者a-TG的发生相关。
结论
TG异常可能是ET综合征患者跌倒风险的预测指标，并且与非运动症状，尤其是抑郁相关。
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