The Effect of Dysautonomia on Motor, Behavioral, and Cognitive Fluctuations in Parkinson's Disease

IF 7.4 1区医学 Q1 CLINICAL NEUROLOGY

Movement Disorders Pub Date : 2024-10-25 DOI:10.1002/mds.30044

Abhimanyu Mahajan MD, MHS, Christopher B. Morrow MD, MHS, Joseph Seemiller MD, Kelly A. Mills MD, MHS, Gregory M. Pontone MD, MHS

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引用次数: 0

Abstract

Background

Motor and nonmotor fluctuations adversely impact the quality of life in Parkinson's disease (PD). Dysautonomia, a feature frequently associated with PD and a possible adverse effect of dopaminergic therapy, may be comorbid with fluctuations.

Objective

We sought to evaluate the effect of dysautonomia on motor and nonmotor fluctuations in PD.

Methods

Two hundred subjects with PD were evaluated in both on and off dopamine states to assess changes in symptoms related to dopaminergic fluctuations. Multivariable logistic regression was performed to assess the association of dysautonomia with motor, cognitive, and psychiatric worsening from on to off states with adjustment for disease duration, levodopa equivalent daily dosage (LEDD), and dopamine-agonist LEDD.

Results

Subjects with dysautonomia had greater odds of clinically meaningful change in motor features (odds ratio [OR]: 3.0), cognition (OR: 3.4), and anxiety (OR: 4.3) compared to those without dysautonomia.

Conclusions

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自主神经功能障碍对帕金森病患者运动、行为和认知波动的影响

背景运动和非运动波动对帕金森病（PD）患者的生活质量产生不利影响。我们试图评估自律神经失调对帕金森病运动和非运动波动的影响。方法对 200 名帕金森病患者进行了多巴胺开启和关闭状态评估，以评估与多巴胺能波动相关的症状变化。在对病程、左旋多巴等效日剂量（LEDD）和多巴胺受体激动剂LEDD进行调整后，进行了多变量逻辑回归，以评估自律神经失调与运动、认知和精神症状从开启状态恶化到关闭状态的关联。结果与无自主神经功能障碍的受试者相比，有自主神经功能障碍的受试者在运动特征（几率比 [OR]：3.0）、认知（OR：3.4）和焦虑（OR：4.3）方面发生有临床意义的变化的几率更大。这种关系的确切性质值得进一步评估。© 2024 国际帕金森病和运动障碍协会。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Movement Disorders 医学-临床神经学

CiteScore

13.30

自引率

8.10%

发文量

371

审稿时长

12 months

期刊介绍： Movement Disorders publishes a variety of content types including Reviews, Viewpoints, Full Length Articles, Historical Reports, Brief Reports, and Letters. The journal considers original manuscripts on topics related to the diagnosis, therapeutics, pharmacology, biochemistry, physiology, etiology, genetics, and epidemiology of movement disorders. Appropriate topics include Parkinsonism, Chorea, Tremors, Dystonia, Myoclonus, Tics, Tardive Dyskinesia, Spasticity, and Ataxia.