"Does the Response to Morning Medication Predict the ADL-Level of the Day in Parkinson's Disease?"

IF 2.1 4区医学 Q3 CLINICAL NEUROLOGY

Parkinson's Disease Pub Date : 2020-07-27 eCollection Date: 2020-01-01 DOI:10.1155/2020/7140984

Trine Hørmann Thomsen, Troels Wesenberg Kjær, Lene Bastrup Jørgensen, Anita Haahr, Kristian Winge

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引用次数: 5

Abstract

Background: Individuals with Parkinson's Disease (PD) have bradykinesia during mobility tasks in the morning before intake of dopaminergic treatment and have difficulties managing Activities of Daily Living (ADLs). Early morning off (EMO) refers to off-states in the morning where the severity of bradykinesia is increased and causes a decrease in mobility related to wearing off of effects of medication. Measurements from devices capable of continuously recording motor symptoms may provide insight into the patient's response to medication and possible impact on ADLs.

Objectives: To test whether poor or slow response to medication in the morning predicts the overall ADL-level and to assess the association between change in bradykinesia score (BKS) and the risk of having disabilities within three selected ADL-items.

Methods: In this cross-sectional study, the sample consists of 34 patients with light to moderate PD. Data collection encompasses measurements from the Parkinson KinetiGraph, and the ADL-limitations are assessed by the Movement Disorder Society Unified Parkinson Disease Rating Scale (MDS-UPDRS) Part II.

Results: The association between UPDRS- II and BKS from the algorithm was -0.082 (p < 0.01), 95% CL:-0.113; -0.042). The individuals experienced disabilities in performing "Speech" (p=0.004) and "Doing hobbies" (p=0.038) when being slow or poor responders to dopaminergic therapy. The PD patients' L-dopa equivalent dose seems to be a strong predictor of the ADL-level in the morning.

Conclusion: Slow response to the medication dosages in the morning is correlated with disabilities in the overall ADL-level in PD. The combination of PD-drugs and precise, timely dosages must be considered in the improvement of the ADL-level in PD patients.

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“早晨用药的反应能否预测帕金森病患者当天的adl水平?”

背景:帕金森氏病(PD)患者在接受多巴胺能治疗前的早晨活动任务中运动迟缓，并且难以管理日常生活活动(adl)。清晨休息(Early morning off, EMO)指的是早晨的休息状态，在这种状态下，运动迟缓的严重程度会增加，并导致与药物效果消退有关的活动能力下降。通过能够连续记录运动症状的设备进行测量，可以深入了解患者对药物的反应以及对adl的可能影响。目的:检验晨起对药物反应不良或反应缓慢是否能预测总体adl水平，并评估运动迟缓评分(BKS)的变化与选定的三个adl项目的残疾风险之间的关系。方法:在本横断面研究中，样本包括34例轻至中度PD患者。数据收集包括帕金森KinetiGraph的测量结果，并通过运动障碍学会统一帕金森病评定量表(MDS-UPDRS)第二部分评估adl限制。结果:UPDRS- II与BKS的相关性为-0.082 (p < 0.01)， 95% CL:-0.113;-0.042)。当对多巴胺能治疗反应缓慢或不良时，个体在“言语”(p=0.004)和“爱好”(p=0.038)方面出现障碍。PD患者的左旋多巴当量剂量似乎是早晨adl水平的一个强有力的预测因子。结论:晨起对药物剂量反应缓慢与PD患者整体adl水平的失能相关。提高PD患者的adl水平必须考虑PD药物的联合使用和准确、及时的给药。

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

Parkinson's Disease CLINICAL NEUROLOGY-

CiteScore

5.80

自引率

3.10%

发文量

审稿时长

18 weeks

期刊介绍： Parkinson’s Disease is a peer-reviewed, Open Access journal that publishes original research articles, review articles, and clinical studies related to the epidemiology, etiology, pathogenesis, genetics, cellular, molecular and neurophysiology, as well as the diagnosis and treatment of Parkinson’s disease.