Martinez-Nunez Alfonso Enrique, Hutchinson Hunter, Coutinho Patricia, Sarmento Filipe Pereira, Lavu Venkat Srikar, Yuan Qingqi, Dwarampudi Jagan Mohan Reddy, Gunduz Aysegul, Pontone Gregory M, Okun Michael S, Wong Joshua K
Norman Fixel Institute for Neurological Disease, University of Florida, Gainesville, FL, USA.
College of Medicine, University of Florida, Gainesville, FL, USA.
NPJ Parkinsons Dis. 2025 Jan 29;11(1):25. doi: 10.1038/s41531-025-00874-8.
Non-motor symptoms (NMS) in Parkinson's disease (PD) significantly impact quality of life, especially in later stages. REM sleep behavior disorder (RBD) affects approximately 42% of all PD patients and frequently precedes motor PD symptoms. RBD is linked to increased rates of depression and cognitive decline. This study explores how early RBD can predict the development of NMS profiles in patients, comparing those with and without early RBD. We identified a unique NMS profile associated with early RBD. These patients had a higher rate of cognitive impairment (M = 326.84, p < 0.001), apathy (M = 332.93, p < 0.001), hallucinations (M = 480.05, p < 0.001), depression (M = 480.05, p < 0.0001), anxiety (corrected p < 0.01), impulse control disorders (M = 77.577, p < 0.001), and autonomic dysfunction (F = 251.8, p < 0001). A survival analysis revealed an association between early RBD and faster progression to cognitive impairment. These NMS profiles may play a critical role in stratifying patients for targeted interventions.
帕金森病（PD）中的非运动症状（NMS）对生活质量有显著影响，尤其是在疾病后期。快速眼动睡眠行为障碍（RBD）影响约42%的PD患者，且常常早于运动性PD症状出现。RBD与抑郁症和认知能力下降的发生率增加有关。本研究探讨早期RBD如何预测患者非运动症状谱的发展，比较有和没有早期RBD的患者。我们确定了一种与早期RBD相关的独特非运动症状谱。这些患者的认知障碍发生率更高（M = 326.84，p < 0.001）、冷漠（M = 332.93，p < 0.001）、幻觉（M = 480.05，p < 0.001）、抑郁（M = 480.05，p < 0.0001）、焦虑（校正p < 0.01）、冲动控制障碍（M = 77.577，p < 0.001）和自主神经功能障碍（F = 251.8，p < 0.0001）。生存分析显示早期RBD与认知障碍的更快进展之间存在关联。这些非运动症状谱可能在对患者进行分层以实施针对性干预方面发挥关键作用。
