Zeng Weiqi, Wang Yukai, Liu Ling, Wu Yi, Xu Yu, Zhai Heng, Yang Xiaoman, Cao Xuebing, Xu Yan
Department of Neurology, The First People's Hospital of Foshan, Foshan, Guangdong, China.
Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Heliyon. 2023 Jul 7;9(7):e18081. doi: 10.1016/j.heliyon.2023.e18081. eCollection 2023 Jul.
The symptoms of early Parkinson's disease (PD) are complex and hidden. The aim of this study is to explore and summarize the characteristics of the symptoms of drug naïve patients with PD.
and Methods Drug-naïve patients with PD and age-matched healthy controls were recruited from the outpatient clinic of Wuhan Union Hospital. The motor and non-motor symptoms were evaluated for further analysis using Unified Parkinson's Disease Rating Scale (UPDRS) I, II, and III; Sniffin' Sticks Screening 12 test; Mini-Mental State Exam (MMSE); Montreal Cognitive Assessment (MoCA); Hamilton Anxiety Scale (HAMA); and Hamilton Depression Scale (HAMD) scores. The acute levodopa challenge test (ALCT) was adopted to assess the reaction to dopaminergic treatment.
We recruited 80 drug-naïve patients with PD and 40 age-matched healthy controls (HCs). Approximately 53.7% of the patients were females. The mean onset age was 59.96 ± 10.40 years. The mean UPDRS I, II, and III were 2.01 ± 1.90, 6.18 ± 3.68, and 26.13 ± 12.09, respectively. Compared with HCs, PD patients had lower scores in MMSE and MoCA; and higher scores in HAMA and HAMD (p < 0.05). In ALCT, 54 patients showed good responses to levodopa while 26 patients did not. The mean improvement rate of UPDRS III was 34.09% at 120 min.
The motor symptoms of patients with early PD were mild but virous. They also suffered from different non-motor symptoms. In ALCT, about two thirds of patients (54/80) with early PD showed good response to levodopa. Among four aspects of motor symptoms, bradykinesia reacted best to ALCT, while axial symptoms were the worst.
早期帕金森病（PD）症状复杂且隐匿。本研究旨在探索并总结初治PD患者的症状特征。
从武汉协和医院门诊招募初治PD患者及年龄匹配的健康对照。使用统一帕金森病评定量表（UPDRS）Ⅰ、Ⅱ和Ⅲ、嗅觉棒筛查12项测试、简易精神状态检查表（MMSE）、蒙特利尔认知评估量表（MoCA）、汉密尔顿焦虑量表（HAMA）和汉密尔顿抑郁量表（HAMD）评分对运动和非运动症状进行评估以作进一步分析。采用急性左旋多巴激发试验（ALCT）评估对多巴胺能治疗的反应。
我们招募了80例初治PD患者和40例年龄匹配的健康对照（HCs）。约53.7%的患者为女性。平均发病年龄为59.96±10.40岁。UPDRSⅠ、Ⅱ和Ⅲ的平均分分别为2.01±1.9起、6.18±3.68和26.13±12.09。与HCs相比，PD患者在MMSE和MoCA中的得分较低；在HAMA和HAMD中的得分较高（p<0.05）。在ALCT中，54例患者对左旋多巴反应良好，而26例患者无反应。120分钟时UPDRSⅢ的平均改善率为34.09%。
早期PD患者的运动症状较轻但多样。他们还存在不同的非运动症状。在ALCT中，约三分之二的早期PD患者（54/80）对左旋多巴反应良好。在运动症状的四个方面中，运动迟缓对ALCT反应最佳，而轴性症状最差。
