Department of Neurology, Aviation General Hospital, Beijing, China.
Ideggyogy Sz. 2024 May 30;77(5-6):161-166. doi: 10.18071/isz.77.0161.
The aim of this study is to comprehensively determine the types of affected fibers in Parkinson’s disease (PD) patients by employing nerve conduction studies (NCS), sympathetic skin response (SSR) examinations, and current perception threshold (CPT) testing and to analyze the correlation between levodopa use and nerve involvement.
.This retrospective study included 36 clinically diagnosed PD patients who were recruited between January 2018 and April 2019. All patients underwent NCS, SSR testing, and CPT sensory examinations. Additionally, the PD patients were assessed for disease staging using the Hoehn and Yahr (H-Y) scale.
.Fifteen patients were included in the tremor-dominant subtype, ten patients in the rigid-dominant subtype, and eleven patients in the mixed subtype. Eleven patients were using levodopa, while twenty-five patients had never used any anti-Parkinson’s medication. Ten patients (28%) showed abnormal sympathetic skin responses (SSR). The CPT examination revealed sensory abnormalities in twenty-four patients (67%), with eighteen patients (75%) experiencing sensory hypersensitivity and six patients (25%) experiencing sensory hypoesthesia. Twelve patients (33%) had normal CPT results. Among the patients with abnormal CPT findings, seven cases (29%) involved large myelinated fiber damage, twenty-two cases (92%) involved small myelinated fiber damage, and nineteen cases (79%) involved unmyelinated fiber damage. The rate of sensory abnormalities was 64% (7/11) in the levodopa group and 68% (17/25) in the non-levodopa group, with no statistically significant difference between the two groups.
.The incidence of abnormal CPT findings in PD patients was higher than that of abnormal SSR responses, suggesting that nerve fiber damage primarily affects small fiber nerves (SFN).
.本研究旨在通过神经传导研究（NCS）、交感皮肤反应（SSR）检查和电流知觉阈值（CPT）测试全面确定帕金森病（PD）患者的受累纤维类型，并分析左旋多巴使用与神经受累之间的相关性。
本回顾性研究纳入了 2018 年 1 月至 2019 年 4 月期间的 36 例临床诊断为 PD 的患者。所有患者均接受 NCS、SSR 检查和 CPT 感觉检查。此外，使用 Hoehn 和 Yahr（H-Y）量表对 PD 患者进行疾病分期评估。
15 例患者为震颤主导型，10 例为僵直主导型，11 例为混合型。11 例患者使用左旋多巴，25 例患者从未使用过任何抗帕金森病药物。10 例（28%）患者的交感皮肤反应（SSR）异常。CPT 检查显示 24 例患者（67%）存在感觉异常，其中 18 例（75%）感觉过敏，6 例（25%）感觉迟钝。12 例（33%）患者的 CPT 结果正常。在 CPT 异常的患者中，7 例（29%）存在大髓鞘纤维损伤，22 例（92%）存在小髓鞘纤维损伤，19 例（79%）存在无髓鞘纤维损伤。左旋多巴组感觉异常发生率为 64%（7/11），非左旋多巴组为 68%（17/25），两组间差异无统计学意义。
PD 患者 CPT 异常发现的发生率高于 SSR 异常反应，提示神经纤维损伤主要影响小纤维神经（SFN）。
