Morimoto Remi, Iijima Mutsumi, Okuma Yasuyuki, Suzuki Keisuke, Yoshii Fumihito, Nogawa Shigeru, Osada Takashi, Kitagawa Kazuo
Department of Neurology, School of Medicine, Tokyo Women's Medical University, Tokyo, Japan.
Department of Neurology, Juntendo University Shizuoka Hospital, Shizuoka, Japan.
Front Aging Neurosci. 2023 Sep 6;15:1252596. doi: 10.3389/fnagi.2023.1252596. eCollection 2023.
Parkinson's disease (PD) is characterized by various non-motor symptoms (NMS), such as constipation, olfactory disturbance, sleep disturbance, mental disorders, and motor symptoms. This study aimed to investigate factors associated with NMS in patients with PD.
Symptoms of PD were evaluated using the Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS), Parts I-IV. NMS was assessed using the MDS-UPDRS Part I (self-assessment of NMS) and rapid eye movement sleep behavior disorder (RBD) questionnaires. Patients were categorized by age into <70 years and ≥ 70 years (older adults) groups, according to disease duration into early-stage and advanced-stage groups with a cut-off value of 5 years for motor symptoms, and by sex into male and female groups.
A total of 431 patients with PD (202 males and 229 females) with a mean age of 67.7 years, a mean disease duration of 6.4 years, and a mean Part I total score of 9.9 participated in this study. The Part I total score was significantly positively correlated ( < 0.01) with disease duration and Part II, III, and IV scores. For Part I sub-item scores, the older group had significantly higher scores for cognitive impairment, hallucinations, sleep problems, urinary problems, and constipation than the <70 years group, whereas the advanced-stage group had significantly higher scores for hallucinations, sleep problems, daytime sleepiness, pain, urinary problems, and constipation ( < 0.05) than the early-stage group. Anxiety was higher in female patients than in male patients, whereas daytime sleepiness, urinary problems, and RBD were higher in male patients than in female patients ( < 0.05). Factors affecting Part I included disease duration, Part II total scores, Part IV total scores, and RBD.
According to the self-questionnaire assessment, NMS was highly severe in older adult patients, those with longer illness duration, subjective and objective motor function impairments, and RBD. Sex-based differences were also observed.
帕金森病（PD）的特征是存在各种非运动症状（NMS），如便秘、嗅觉障碍、睡眠障碍、精神障碍和运动症状。本研究旨在调查PD患者中与NMS相关的因素。
使用运动障碍协会统一帕金森病评定量表（MDS-UPDRS）第I-IV部分评估PD症状。使用MDS-UPDRS第I部分（NMS自我评估）和快速眼动睡眠行为障碍（RBD）问卷评估NMS。根据年龄将患者分为<70岁组和≥70岁（老年人）组，根据疾病持续时间分为运动症状的截止值为5年的早期和晚期组，并根据性别分为男性和女性组。
共有431例PD患者（202例男性和229例女性）参与本研究，平均年龄67.7岁，平均疾病持续时间6.4年，第I部分总分平均为9.9分。第I部分总分与疾病持续时间以及第II、III和IV部分得分显著正相关（<0.01）。对于第I部分子项得分，老年组在认知障碍、幻觉、睡眠问题、泌尿问题和便秘方面的得分显著高于<70岁组，而晚期组在幻觉、睡眠问题、日间嗜睡、疼痛、泌尿问题和便秘方面的得分显著高于早期组（<0.05）。女性患者的焦虑程度高于男性患者，而男性患者的日间嗜睡、泌尿问题和RBD高于女性患者（<0.05）。影响第I部分的因素包括疾病持续时间、第II部分总分、第IV部分总分和RBD。
根据自我问卷评估，NMS在老年患者、病程较长者、主观和客观运动功能受损者以及RBD患者中非常严重。还观察到了基于性别的差异。
