Fründt Odette, Hanff Anne-Marie, Möhl Annika, Mai Tobias, Kirchner Christiane, Amouzandeh Ali, Buhmann Carsten, Krüger Rejko, Südmeyer Martin
Department of Neurology, Klinikum Ernst von Bergmann, Charlottenstraße 72, 14467 Potsdam, Germany.
Transversal Translational Medicine, Luxembourg Institute of Health (LIH), 1A-B, Rue Thomas Edison, L-1445 Strassen, Luxembourg.
Brain Sci. 2023 Apr 28;13(5):736. doi: 10.3390/brainsci13050736.
Data on the use of device-aided therapies (DATs) in people with Parkinson's disease (PwP) are scarce. Analyzing data from the Care4PD patient survey, we (1) evaluated application frequency and type of DAT in a larger, nationwide, cross-sectoral PwP sample in Germany; (2) analyzed the frequency of symptoms indicative for advanced PD (aPD) and need for DAT amongst the remaining patients and (3) compared the most bothersome symptoms and need for professional long-term care (LTC) of patients with and without suspected aPD. Data from 1269 PwP were analyzed. In total, 153 PwP (12%) received DAT, mainly deep brain stimulation (DBS). Of the remaining 1116 PwP without DAT, >50% fulfilled at least one aPD criterion. Akinesia/rigidity and autonomic problems were most bothersome for PwP with and without suspected aPD, with more tremor in the non-aPD and more motor fluctuations and falls in the aPD group. To recapitulate, the German DAT application rate is rather low, although a large proportion of PwP fulfills aPD criteria indicating a need for intensified treatment strategies. Many reported bothersome symptoms could be overcome with DAT with benefits even for LTC patients. Thus, precise and early identification of aPD symptoms (and therapy-resistant tremor) should be implemented in future DAT preselection tools and educational trainings.
关于帕金森病患者(PwP)使用设备辅助疗法(DATs)的数据很少。通过分析Care4PD患者调查的数据,我们(1)在德国一个更大的、全国性的、跨部门的PwP样本中评估了DAT的应用频率和类型;(2)分析了其余患者中晚期帕金森病(aPD)指示性症状的频率以及对DAT的需求;(3)比较了疑似aPD患者和非疑似aPD患者最困扰的症状以及对专业长期护理(LTC)的需求。对1269名PwP的数据进行了分析。总共有153名PwP(12%)接受了DAT,主要是深部脑刺激(DBS)。在其余1116名未接受DAT的PwP中,超过50%至少符合一项aPD标准。对于疑似aPD和非疑似aPD的PwP来说,运动不能/僵硬和自主神经问题最困扰他们,非aPD组震颤更多,而aPD组运动波动和跌倒更多。概括来说,德国DAT的应用率相当低,尽管很大一部分PwP符合aPD标准,表明需要强化治疗策略。许多报告的困扰症状可以通过DAT克服,即使对LTC患者也有益处。因此,未来的DAT预选工具和教育培训应实施对aPD症状(和治疗抵抗性震颤)的精确和早期识别。