Impact of motor features on non-motor symptoms in patients with de novo Parkinson's disease: Cognition, depression, anxiety, fatigue, and dysautonomia

IF 2.4 4区医学 Q3 GERIATRICS & GERONTOLOGY

Geriatrics & Gerontology International Pub Date : 2025-01-20 DOI:10.1111/ggi.15083

Kyum-Yil Kwon, Byung-Euk Joo, Jihwan You, Rae On Kim

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引用次数: 0

Abstract

Aim

Patients with Parkinson's disease (PD) present with both motor and non-motor symptoms, and understanding the interplay between these symptoms is crucial for individualized patient care. This study aims to investigate the relationship between motor features and non-motor symptoms in patients with de novo PD.

Methods

A total of 105 patients were analyzed, focusing on motor subtypes or subscores and their impact on cognition, depression, anxiety, fatigue, and dysautonomia. We utilized the Unified Parkinson's Disease Rating Scale–part III (UPDRS-III) for motor assessment, and various validated scales for non-motor symptoms.

Results

Compared with tremor-dominant (TD) patients, non-TD patients showed severe scores in fatigue and dysautonomia, but no difference in other non-motor symptoms, including global cognition, depression, and anxiety. Linear regression analysis revealed that the total motor score of UPDRS-III was negatively related to global cognition (β = −0.4454, P = 0.0121). As a post-hoc analysis, partial correlation analysis showed that rigidity and bradykinesia subscores were associated with global cognition (r = −0.3527, P = 0.0004; r = −0.2206, P = 0.0299, respectively), whereas the postural instability/gait difficulty subscore was associated with depression, anxiety, fatigue, and dysautonomia (r = 0.2181, P = 0.0319; r = 0.2371, P = 0.0194; r = 0.3659, P = 0.0002; r = 0.3968, P = 0.0001, respectively) but not with global cognition.

Conclusions

These results suggest that motor features in the early stages of PD can serve as important indicators of non-motor symptoms, potentially guiding more personalized therapeutic approaches. Geriatr Gerontol Int 2025; 25: 392–397.

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运动特征对新生帕金森病患者非运动症状的影响：认知、抑郁、焦虑、疲劳和自主神经异常

目的：帕金森病（PD）患者同时存在运动和非运动症状，了解这些症状之间的相互作用对于个体化患者护理至关重要。本研究旨在探讨PD患者运动特征与非运动症状之间的关系。方法：对105例患者进行分析，重点分析运动亚型或亚分及其对认知、抑郁、焦虑、疲劳和自主神经障碍的影响。我们使用统一帕金森病评定量表-第三部分（UPDRS-III）进行运动评估，并使用各种经过验证的量表进行非运动症状评估。结果：与震颤显性（TD）患者相比，非TD患者在疲劳和自主神经异常方面表现出严重的评分，但在其他非运动症状，包括整体认知、抑郁和焦虑方面没有差异。线性回归分析显示，UPDRS-III总分与整体认知呈负相关（β = -0.4454, P = 0.0121）。事后分析显示，偏相关分析显示，僵硬和运动迟缓亚评分与整体认知相关(r = -0.3527, P = 0.0004；r = -0.2206, P = 0.0299)，而姿势不稳定/步态困难亚评分与抑郁、焦虑、疲劳和自主神经异常相关(r = 0.2181, P = 0.0319；r = 0.2371, P = 0.0194；r = 0.3659, P = 0.0002；r = 0.3968, P = 0.0001)，但与全局认知无关。结论：这些结果表明，PD早期的运动特征可以作为非运动症状的重要指标，可能指导更个性化的治疗方法。Geriatr Gerontol 2025；••: ••-••.

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来源期刊

Geriatrics & Gerontology International 医学-老年医学

CiteScore

5.50

自引率

6.10%

发文量

189

审稿时长

4-8 weeks

期刊介绍： Geriatrics & Gerontology International is the official Journal of the Japan Geriatrics Society, reflecting the growing importance of the subject area in developed economies and their particular significance to a country like Japan with a large aging population. Geriatrics & Gerontology International is now an international publication with contributions from around the world and published four times per year.