可穿戴设备可能有助于识别帕金森病中与波动相关的疼痛——两项前瞻性观察性研究的探索性横断面分析。

Wearable devices may aid the recognition of fluctuation-related pain in Parkinson's disease-An exploratory, cross-sectional analysis of two prospective observational studies.

作者信息

Rukavina Katarina, Staunton Juliet, Zinzalias Pavlos, Krbot Skoric Magdalena, Wu Kit, Bannister Kirsty, Rizos Alexandra, Ray Chaudhuri K

机构信息

Institute of Psychiatry, Psychology & Neuroscience at King's College London, London, United Kingdom.

Parkinson's Foundation Centre of Excellence, King's College Hospital NHS Foundation Trust, London, United Kingdom.

出版信息

PLoS One. 2025 Jan 14;20(1):e0316563. doi: 10.1371/journal.pone.0316563. eCollection 2025.

Abstract

Fluctuation-related pain (FRP) affects more than one third of people with Parkinson's disease (PwP, PD) and has a harmful effect on health-related quality of life (HRQoL), but often remains under-reported by patients and neglected by clinicians. The National Institute for Health and Care Excellence (NICE) recommends The Parkinson KinetiGraphTM (the PKGTM) for remote monitoring of motor symptoms. We investigated potential links between the PKGTM-obtained parameters and clinical rating scores for FRP in PwP in an exploratory, cross-sectional analysis of two prospective studies: "The Non-motor International Longitudinal, Real-Life Study in PD-NILS" and "An observational-based registry of baseline PKG™ in PD-PKGReg". 63 PwP (41.3% female; age: 64.24±9.88 years; disease duration, DD: 6.83±5.63 years; Hoehn and Yahr Stage, H&Y: 2 (1-4); Levodopa Equivalent Daily Dose 535 (0-3230) mg) were included. PwP with FRP (n = 23) had longer DD (8.88 (1.29-19.05) vs. 3.16 (0.34-28.92), p = 0.001), higher severity of motor symptoms (H&Y 3 (1-4) vs. 2 (1-4), p = 0.015; SCOPA Motor total score 21.35±10.19 vs. 13.65±8.99, p = 0.003), more dyskinesia (SCOPA Motor Item 18 ≥1 60.9% vs. 7.5%, p<0.001), and worse HRQoL (PDQ-8 Total Score 10.74±5.98 vs. 6.78±5.13, p = 0.007) then PwP without FRP (n = 40). In the multivariate logistic regression, after the adjustment for DD, H&Y and SCOPA-Motor total score, the presence of FRP was significantly associated with the PKGTM-derived Fluctuation-dyskinesia score (Exp (B) = 1.305, 95% CI for Exp (B) 1.012-1.683, p = 0.040) and the Bradykinesia score (Exp (B) = 0.917, 95% CI for Exp (B) 0.842-0.999, p = 0.048). The PKGTM system may potentially advance the way we screen for, assess, and treat FRP in clinical practice.

摘要

波动相关疼痛(FRP)影响超过三分之一的帕金森病患者(PwP,PD),并对健康相关生活质量(HRQoL)产生有害影响,但患者往往报告不足,临床医生也常忽视。英国国家卫生与临床优化研究所(NICE)推荐使用帕金森运动记录仪(Parkinson KinetiGraphTM,PKGTM)对运动症状进行远程监测。在两项前瞻性研究“帕金森病非运动国际纵向现实生活研究-NILS”和“基于观察的帕金森病PKG™基线注册研究-PKGReg”的探索性横断面分析中,我们研究了PKGTM获得的参数与PwP中FRP临床评分之间的潜在联系。纳入了63例PwP(女性占41.3%;年龄:64.24±9.88岁;病程,DD:6.83±5.63年; Hoehn和Yahr分期,H&Y:2(1-4)期;左旋多巴等效日剂量535(0-3230)mg)。与无FRP的PwP(n = 40)相比,有FRP的PwP(n = 23)病程更长(8.88(1.29-19.05)对3.16(0.34-28.92),p = 0.001),运动症状严重程度更高(H&Y 3(1-4)期对2(1-4)期,p = 0.015;SCOPA运动总分21.35±10.19对13.65±8.99,p = 0.003),异动症更多(SCOPA运动项目18≥1 60.9%对7.5%,p<0.001),HRQoL更差(PDQ-8总分10.74±5.98对6.78±5.13,p = 0.007)。在多因素逻辑回归中,在对病程、H&Y和SCOPA运动总分进行调整后,FRP的存在与PKGTM得出的波动-异动症评分(Exp(B)= 1.305,Exp(B)的95%置信区间为1.012-1.683,p = 0.040)和运动迟缓评分(Exp(B)= 0.917,Exp(B)的95%置信区间为0.842-0.999,p = 0.048)显著相关。PKGTM系统可能会潜在地改进我们在临床实践中筛查、评估和治疗FRP的方式。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b5d5/11731749/f318f851a649/pone.0316563.g001.jpg

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