探索帕金森病疲劳的层次:全面分析帕金森病的发病率和诱因

IF 1.9 Q3 CLINICAL NEUROLOGY
Filipe Sarmento , Griffin Lamp , Venkat Srikar Lavu , Achyutha S. Madamangalam , Jagan Mohan Reddy Dwarampudi , Qingqi Yuan , Alfonso Enrique Martinez-Nunez , Julia Choi , Kara A. Johnson , Coralie de Hemptinne , Joshua K. Wong
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引用次数: 0

摘要

背景疲劳是帕金森病(PD)的一种普遍但未得到充分认识的非运动症状(NMS),严重影响患者的生活质量。尽管疲劳具有重要的临床意义,但人们对疲劳与其他运动症状和非运动症状之间的关系仍然知之甚少。疲劳经常与其他非运动症状同时出现,使诊断和治疗更加复杂,往往导致诊断不足和治疗效果不佳。本研究旨在评估一个大型、特征明确的帕金森病队列(PPMI)中基线和症状发作后长达 10 年的疲劳患病率,并探讨其与其他非运动症状(NMS)的关联。通过深入了解疲劳的患病率和相关性,我们的目标是强调早期识别和管理的必要性,为未来的研究工作提供指导。我们利用 PPMI 数据库进行了一项回顾性研究,采用运动障碍协会帕金森病统一评分量表的第 1.13 项对疲劳进行评估。采用逻辑回归分析了不同变量对疲劳的影响,而点-阶梯相关分析则衡量了连续变量与疲劳之间的关系。 结果在基线研究访问中,52%(575 人)的患者报告出现疲劳,其中 9% 的患者在病程早期报告出现中度至重度疲劳。多个量表的较高评分与疲劳风险的增加有显著相关性,但大多数相关性较弱。显著相关的量表包括快速眼动睡眠行为障碍问卷(OR:1.09,95% CI:1.06-1.11)、老年抑郁量表(OR:1.07,95% CI:1.03-1.11)、状态-特质焦虑量表(OR:1.01,95% CI:1.00-1.02)、SCOPA-自主神经功能障碍(OR:1.结论:超过一半的患者在基线时报告有疲劳症状,这表明疲劳在帕金森病早期的发病率很高。与其他 NMS 的关联性较弱,这突出表明有必要对患者进行全面筛查并采取有针对性的干预措施,因为治疗一种 NMS 可能无法有效缓解其他 NMS。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Exploring the layers of fatigue in Parkinson’s Disease: A comprehensive analysis of its prevalence and contributing factors

Background

Fatigue is a prevalent yet under-recognized non-motor symptom (NMS) of Parkinson’s disease (PD), significantly impacting patients’ quality of life. Despite its clinical importance, the relationship between fatigue and other motor and non-motor symptoms remains poorly understood. Its frequent co-occurrence with other NMS further complicates both diagnosis and management, often leading to underdiagnosis and suboptimal treatment. This gap in understanding is largely due to the limited exploration of fatigue in PD.

Objective

This study aimed to evaluate the prevalence of fatigue at baseline and up to 10 years after symptom onset in a large, well-characterized PD cohort (PPMI) and to explore its associations with other non-motor symptoms (NMS). By providing insights into the prevalence and correlations of fatigue, our goal is to highlight the need for early identification and management, guiding future research efforts.

Methods

 We conducted a retrospective study using the PPMI database. Fatigue was assessed using item 1.13 of the Movement Disorders Society Unified Parkinson’s Disease Rating Scale. Logistic regression was used to analyze the impact of different variables on fatigue, while point-biserial correlation analysis gauged the relationship between continuous variables and fatigue.

Results

At baseline study visit, 52% (575) of patients reported experiencing fatigue, with 9% reporting moderate to severe fatigue early in the disease course. Higher scores on several scales were significantly associated with an increased risk of fatigue, though most associations were weak. Significant associations included the REM Sleep Behavioral Disorder Questionnaire (OR: 1.09, 95% CI: 1.06–1.11), Geriatric Depression Scale (OR: 1.07, 95% CI: 1.03–1.11), State-Trait Anxiety Inventory (OR: 1.01, 95% CI: 1.00–1.02), SCOPA-Autonomic Dysfunction (OR: 1.05, 95% CI: 1.03–1.06), Epworth Sleepiness Scale (OR: 1.06, 95% CI: 1.04–1.08), and Apathy (OR: 2.90, 95% CI: 2.4–3.5).

Conclusion

Over half of patients reported fatigue at baseline, underscoring its significant prevalence early in PD. The predominantly weak associations with other NMS highlight the necessity for comprehensive patient screening and targeted interventions, as addressing one NMS may not effectively alleviate others.
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来源期刊
Clinical Parkinsonism  Related Disorders
Clinical Parkinsonism Related Disorders Medicine-Neurology (clinical)
CiteScore
2.70
自引率
0.00%
发文量
50
审稿时长
98 days
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