Center for Cognitive Neurology, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China.
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China.
BMC Geriatr. 2024 May 16;24(1):433. doi: 10.1186/s12877-024-04854-0.
This study was performed to explore the differences in the clinical characteristics and oxidative stress indicators, inflammatory factors, and pathological proteins in serum between Parkinson's disease (PD) with anxiety (PD-A) and with no anxiety (PD-NA) patients, and further correlations among clinical characteristics and above variables were analyzed in PD-A and PD-NA groups.
A total of 121 patients with PD were enrolled in this study and assessed by the Hamilton Anxiety Scale (14 items) (HAMA-14). These patients were divided into PD-A and PD-NA groups according to a cut-off point of 7 of HAMA-14. Demographic variables were collected, and clinical symptoms were assessed by multiple rating scales. The levels of free radicals, inflammatory factors, and pathological proteins in serum were measured by chemical colorimetric method and enzyme-linked immunosorbent assay (ELISA). The differences of above variables were compared between PD-A and PD-NA groups, and the correlations of clinical symptoms with the abovevariables were analyzed in PD-A and PD-NA groups.
The frequency of PD-A was 62.81%. PD-A group exhibited significantly impaired motor dysfunction and multiple non-motor symptoms, including fatigue, sleep behavior disorder, restless leg syndrome and autonomic dysfunction, and dramatically compromised activities of daily living compard with PD-NA group. PD-A group displayed prominently increasedlevels of hydroxyl radical (·OH) and tumor necrosis factor (TNF)-α, and a decreased nitric oxide (NO) level in serum compared with PD-NA group (P<0.001, P = 0.001, P= 0.027, respectively). ·OH, NO, and TNF-α were identified as the risk factors of PD-A (OR = 1.005, P = 0.036; OR = 0.956, P = 0.017; OR = 1.039, P = 0.033, respectively). In PD patients, HAMA-14 score was significantly and positively correlated with the levels of ·OH and TNF-α in serum (P<0.001, P = 0.002, respectively). In PD-A group, ·OH level was significantly and negatively correlated with Aβ level, while TNF-α level was significantly and positively correlated with P-tau (S396) level in serum.
The frequency of PD-A is high. PD-A patients present more severe motor dysfunction and multiple non-motor symptoms, and poorer activities of daily living. The increased levels of ·OH and TNF-α levels and the decreased NO level in serum are all associated with more severe anxiety in PD patients.Findings from this study may provide in-depth insights into the clinical characteristics, underlying mechanisms of PD-A, and potential correlations among anxiety, oxidative stress, inflammation, and cognitive decline in PD patients.
本研究旨在探讨帕金森病（PD）伴焦虑（PD-A）与不伴焦虑（PD-NA）患者在临床特征和氧化应激指标、炎症因子及血清病理蛋白方面的差异，并进一步分析 PD-A 和 PD-NA 组中临床特征与上述变量之间的相关性。
共纳入 121 例 PD 患者，采用汉密尔顿焦虑量表（14 项）（HAMA-14）进行评估。根据 HAMA-14 的截断值 7 将这些患者分为 PD-A 和 PD-NA 组。收集人口统计学变量，并采用多项评定量表评估临床症状。采用化学比色法和酶联免疫吸附试验（ELISA）检测血清中自由基、炎症因子和病理蛋白的水平。比较 PD-A 和 PD-NA 组之间上述变量的差异，并分析 PD-A 和 PD-NA 组中临床症状与上述变量的相关性。
PD-A 的频率为 62.81%。与 PD-NA 组相比，PD-A 组运动功能障碍和多种非运动症状明显加重，包括疲劳、睡眠行为障碍、不宁腿综合征和自主神经功能障碍，日常生活活动能力明显受损。与 PD-NA 组相比，PD-A 组血清羟自由基（·OH）和肿瘤坏死因子（TNF）-α水平显著升高，一氧化氮（NO）水平显著降低（P<0.001，P=0.001，P=0.027，分别）。·OH、NO 和 TNF-α被确定为 PD-A 的危险因素（OR=1.005，P=0.036；OR=0.956，P=0.017；OR=1.039，P=0.033，分别）。在 PD 患者中，HAMA-14 评分与血清·OH 和 TNF-α水平呈显著正相关（P<0.001，P=0.002，分别）。在 PD-A 组中，·OH 水平与 Aβ水平呈显著负相关，而 TNF-α水平与血清 P-tau（S396）水平呈显著正相关。
PD-A 的频率较高。PD-A 患者表现出更严重的运动功能障碍和多种非运动症状，以及更差的日常生活活动能力。血清中·OH 和 TNF-α水平升高，NO 水平降低与 PD 患者更严重的焦虑有关。本研究结果可能为深入了解 PD-A 的临床特征、潜在机制以及 PD 患者焦虑、氧化应激、炎症和认知衰退之间的潜在相关性提供依据。
