Selected risk factors for motor fluctuations in Parkinson's disease: a meta-analysis

IF 1.8 4区医学 Q3 CLINICAL NEUROLOGY

Clinical Neurology and Neurosurgery Pub Date : 2025-05-24 DOI:10.1016/j.clineuro.2025.108921

Qiaoying Huang , Huayu Weng , Xiaobai Weng , Zhen-Hua Zhao

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引用次数: 0

Abstract

Background

Motor fluctuations are a common and disabling complication of Parkinson's disease (PD), impairing patients’ quality of life and imposing a healthcare burden. Our study aimed to comprehensively assess the risk factors for motor fluctuations in patients with PD.

Methods

We conducted a systematic search up to September 2023, utilizing PubMed, Embase, Web of Science, SCOPUS and Google Scholar. Cohort and case–control studies that clearly defined motor fluctuations and presented relevant data were included. The data were analyzed to generate a pooled effect size and 95 % confidence interval (CI).

Results

Our meta-analysis included 13 studies involving a total of 3346 patients with PD, of whom 1194 (35.7 %) had motor fluctuations. The development of motor fluctuations was positively associated with female sex (HR 1.44, 95 % CI 1.12–1.86), levodopa dose (HR 1.20, 95 % CI 1.14–1.27), years of education (OR 1.34, 95 % CI 1.06–1.69), and higher Unified Parkinson's Disease Rating Scale (UPDRS) motor score (HR 1.02, 95 % CI 1.00–1.04). Conversely, age at diagnosis (HR 0.95, 95 % CI 0.94–0.97) and age at PD onset (HR 0.92, 95 % CI 0.86–0.99) were inversely associated with motor fluctuations. No significant associations were found between motor fluctuations and Hoehn & Yahr stage III, disease duration, tremor-dominant subtype, smoking (ever vs. never), caffeine intake or longer levodopa treatment duration.

Conclusions

Several factors were identified as associated with motor fluctuations in PD. These findings may aid in discerning patients who are at risk of developing motor fluctuations and optimizing their treatment strategies.

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帕金森病运动波动的选定危险因素：一项荟萃分析

运动波动是帕金森病（PD）常见的致残并发症，损害患者的生活质量并增加医疗负担。我们的研究旨在全面评估PD患者运动波动的危险因素。方法利用PubMed、Embase、Web of Science、SCOPUS、谷歌Scholar等数据库进行系统检索，检索时间截止到2023年9月。纳入了明确定义运动波动并提供相关数据的队列研究和病例对照研究。对数据进行分析以产生合并效应大小和95 %置信区间（CI）。我们的荟萃分析包括13项研究，共涉及3346例PD患者，其中1194例（35.7 %）有运动波动。运动波动的发生与女性（HR 1.44, 95 % CI 1.12-1.86）、左旋多巴剂量（HR 1.20, 95 % CI 1.14-1.27）、受教育年数（OR 1.34, 95 % CI 1.06-1.69）和较高的统一帕金森病评定量表（UPDRS）运动评分（HR 1.02, 95 % CI 1.00-1.04）呈正相关。相反，诊断年龄（HR 0.95, 95 % CI 0.94-0.97）和PD发病年龄（HR 0.92, 95 % CI 0.86-0.99）与运动波动呈负相关。没有发现运动波动与Hoehn &；Yahr III期，疾病持续时间，震颤显性亚型，吸烟（曾经与从未），咖啡因摄入或更长左旋多巴治疗时间。结论PD患者运动波动与多种因素相关。这些发现可能有助于识别有运动波动风险的患者并优化他们的治疗策略。

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

Clinical Neurology and Neurosurgery 医学-临床神经学

CiteScore

3.70

自引率

5.30%

发文量

358

审稿时长

46 days

期刊介绍： Clinical Neurology and Neurosurgery is devoted to publishing papers and reports on the clinical aspects of neurology and neurosurgery. It is an international forum for papers of high scientific standard that are of interest to Neurologists and Neurosurgeons world-wide.