Department of Neurology, Affiliated Brain Hospital of Nanjing Medical University, Nanjing, People's Republic of China.
The Yancheng School of Clinical Medicine of Nanjing Medical University, Yancheng Third People's Hospital, Yancheng, People's Republic of China.
J Neural Transm (Vienna). 2024 Apr;131(4):315-322. doi: 10.1007/s00702-024-02756-4. Epub 2024 Mar 28.
Parkinson's disease (PD) is a highly heterogeneous neurodegenerative disorder with varying clinical subtypes. Recently, a novel classification called MNCD (Motor/Non-motor/Cognition/Dependency) has been proposed, which can also include staging based on disease severity. We aim to investigate which staging, the MNCD classification and staging or Hoehn and Yahr (H&Y) staging, exhibits a stronger correlation with the 39-item Parkinson's Disease Questionnaire (PDQ-39). In a cross-sectional study conducted at our single center, 357 PD patients were recruited. Data encompassed scores from various assessments such as the Movement Disorder Society of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS) Parts I, II, III and IV, Montreal Cognitive Assessment (MoCA), PDQ-39, and the H&Y scale. The mean age of these patients was 66.4 ± 9.1 years old, and the majority (54.6%) were male. MNCD stages: stage 1 (N = 3, 0.8%), stage 2 (N = 62, 17.4%), stage 3 (N = 187, 52.4%), stage 4 (N = 86, 24.1%), and stage 5 (N = 19, 5.3%). The top 5 most frequent PD-related clinical symptoms were sleep disturbances (89.6%), fatigue (69.7%), mild cognitive impairment (68.9%), constipation (65.8%), and postural instability (65.5%). The PDQ-39 demonstrated a positive correlation with both MNCD staging and H&Y staging. Moreover, the MNCD staging exhibited a stronger correlation with PDQ-39 compared to H&Y staging. The correlation between the MNCD classification and staging with the quality of life in PD patients is more statistically significant compared to the H&Y staging.
帕金森病(PD)是一种高度异质性的神经退行性疾病,具有不同的临床亚型。最近,提出了一种新的分类方法,称为 MNCD(运动/非运动/认知/依赖),它也可以包括根据疾病严重程度进行分期。我们旨在研究哪种分期,MNCD 分类和分期或 Hoehn 和 Yahr(H&Y)分期与 39 项帕金森病问卷(PDQ-39)的相关性更强。在我们的单中心进行的一项横断面研究中,招募了 357 名 PD 患者。数据包括来自各种评估的评分,例如运动障碍协会统一帕金森病评定量表(MDS-UPDRS)第 I、II、III 和 IV 部分、蒙特利尔认知评估(MoCA)、PDQ-39 和 H&Y 量表。这些患者的平均年龄为 66.4±9.1 岁,大多数(54.6%)为男性。MNCD 分期:第 1 期(N=3,0.8%),第 2 期(N=62,17.4%),第 3 期(N=187,52.4%),第 4 期(N=86,24.1%),第 5 期(N=19,5.3%)。最常见的 5 种与 PD 相关的临床症状是睡眠障碍(89.6%)、疲劳(69.7%)、轻度认知障碍(68.9%)、便秘(65.8%)和姿势不稳(65.5%)。PDQ-39 与 MNCD 分期和 H&Y 分期均呈正相关。此外,与 H&Y 分期相比,MNCD 分期与 PDQ-39 的相关性更强。与 H&Y 分期相比,MNCD 分类和分期与 PD 患者生活质量的相关性在统计学上更为显著。