Department of Neurology, University of Rochester, Rochester, NY, USA.
Center for Health & Technology, University of Rochester, Rochester, NY, USA.
J Geriatr Psychiatry Neurol. 2024 Mar;37(2):134-145. doi: 10.1177/08919887231195220. Epub 2023 Aug 5.
Minor phenomena, including passage phenomena, feeling of presence, and illusions, are common and may represent a prodromal form of psychosis in Parkinson's disease (PD). We examined the prevalence and clinical correlates of minor phenomena, and their potential role as a risk factor for PD psychosis.
A novel questionnaire, the Psychosis and Mild Perceptual Disturbances Questionnaire for PD (PMPDQ), was completed by Fox Insight cohort participants with and without PD. Additional assessments included the Non-Motor Symptoms Questionnaire (NMSQuest), REM Sleep Behavior Disorder Single Question Screen (RBD1Q), Movement Disorder Society-Unified Parkinson Disease Rating Scale Part II, demographic features, and medication usage. For participants with PD, we used regression models to identify clinical associations and predictors of incident psychosis over one year of follow-up.
Among participants with PD (n = 5950) and without PD (n = 1879), the prevalence of minor phenomena was 43.1% and 31.7% ( < .001). Of the 3760 participants with PD and no baseline psychosis, independent correlates of minor phenomena included positive responses on the NMSQuest apathy/attention/memory (OR 1.7, 95% CI 1.3-2.1, < .001) or sexual function domain (OR 1.3, 95% CI 1.1-1.6, = .01) and positive RBD1Q (OR 1.3, 95% CI 1.05-1.5, = .01). Independent risk factors for incident PD psychosis included the presence of minor phenomena (HR 3.0, 95% CI 2.4-3.9, < .001), positive response on the NMSQuest apathy/attention/memory domain (HR 1.8, 95% CI 1.3-2.6, < .001), and positive RBD1Q (HR 1.5, 95% CI 1.1-1.9, = .004).
Minor phenomena are common, associated with specific non-motor symptoms, and an independent predictor of incident psychosis in PD.
在帕金森病（PD）中，包括幻觉在内的轻微现象，如感觉存在和感觉传递现象，是常见的，可能代表精神病的前驱形式。我们研究了轻微现象的患病率和临床相关性，以及它们作为 PD 精神病风险因素的潜在作用。
一项新的问卷，即帕金森病精神病和轻度知觉障碍问卷（PMPDQ），由 FoxInsight 队列中患有和不患有 PD 的参与者完成。其他评估包括非运动症状问卷（NMSQuest）、快速眼动睡眠行为障碍单一问题筛查（RBD1Q）、运动障碍协会统一帕金森病评定量表第二部分、人口统计学特征和药物使用情况。对于患有 PD 的参与者，我们使用回归模型来确定一年内随访中与精神病相关的临床关联和预测因素。
在患有 PD（n=5950）和无 PD（n=1879）的参与者中，轻微现象的患病率分别为 43.1%和 31.7%（<.001）。在 3760 名无基线精神病的 PD 参与者中，与轻微现象独立相关的因素包括 NMSQuest 冷漠/注意力/记忆阳性反应（比值比 1.7，95%置信区间 1.3-2.1，<.001）或性功能域（比值比 1.3，95%置信区间 1.1-1.6，=.01）和阳性 RBD1Q（比值比 1.3，95%置信区间 1.05-1.5，=.01）。PD 精神病事件的独立危险因素包括轻微现象（风险比 3.0，95%置信区间 2.4-3.9，<.001）、NMSQuest 冷漠/注意力/记忆域阳性反应（风险比 1.8，95%置信区间 1.3-2.6，<.001）和阳性 RBD1Q（风险比 1.5，95%置信区间 1.1-1.9，=.004）。
轻微现象很常见，与特定的非运动症状相关，是 PD 精神病事件的独立预测因素。
