性别对帕金森病非运动症状进展的影响：一项基于登记的队列研究

IF 3.1 4区医学 Q2 CLINICAL NEUROLOGY

Neurologia Pub Date : 2025-09-01 DOI:10.1016/j.nrl.2023.02.008

A. Murueta-Goyena , R. Del Pino , M. Carmona-Abellán , B. Tijero , M. Ruiz-Lopez , M. Acera , T. Morera-Herreras , C. Miguelez , O. Sáez-Atxukarro , T. Fernández-Valle , I. Gabilondo , J.C. Gómez-Esteban

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引用次数: 0

摘要

男性和女性帕金森病（PD）患者在病程中的非运动症状（NMS）轨迹差异尚不清楚。方法spd患者在两个时间点采用非运动症状量表（NMSS）进行评分，中位随访3.8年（IQR 2.1-5.6年）。登记性别、年龄、病程、统一帕金森病评定量表和pd相关药物剂量。采用线性混合模型（lmm）和多项逻辑回归模型（MLR）探讨性别与NMSS域随时间变化的关系。结果共纳入87例PD患者，其中女性30例，男性57例。女性和男性PD患者的基线人口学和临床特征相似。NMS频率和严重程度随时间的平均增加不显著，疾病持续时间×性别的相互作用项也不显著。然而，男性和女性的胃肠道症状都恶化了。根据NMSS最小可检出变化，50%的PD患者随访时出现超出量表测量误差的变化。男性预测性功能恶化（校正OR = 10.1, p = 0.038）。此外，在基线时症状更严重的PD患者随着时间的推移改善的几率增加。然而，注意/记忆和心血管领域的高初始得分也使个体具有更高的症状恶化风险（OR [95% CI] = 1.4 [1.0-1.8], p = 0.034, OR [95% CI] = 2.1 [1.2-3.7], p = 0.01）。结论PD患者nms在病程中的进展具有较大的个体差异，无明显的性别影响。

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Effect of sex on the progression of non-motor symptoms in Parkinson's disease: A registry-based cohort study

Introduction

Differences in the trajectory of non-motor symptoms (NMS) between male and female Parkinson's disease (PD) patients over the course of the disease are not well-understood.

Methods

PD patients were rated with Non-Motor Symptom Scale (NMSS) at two time points with a median follow-up of 3.8 years (IQR 2.1–5.6 years). Sex, age, disease duration, Unified Parkinson's Disease Rating Scale and doses of PD-related medication were registered. Linear mixed models (LMMs) and multinomial logistic regression (MLR) models were fitted to explore the association of sex with changes in NMSS domains over time.

Results

Eighty-seven PD patients (30 females and 57 males) were enrolled. Baseline demographic and clinical characteristics were similar between female and male PD patients. The mean increase in NMS frequency and severity over time was non-significant, as well as the interaction term for disease duration × sex. However, gastrointestinal symptoms worsened in both males and females. According to the minimal detectable change of NMSS, <50% of PD patients experienced changes at follow-up beyond measurement error of the scale. Male sex predicted sexual function worsening (adjusted OR = 10.1, p = 0.038). Also, PD patients with more severe symptoms at baseline had increased odds of improving over time. However, high initial scores in attention/memory and cardiovascular domains also posed individuals at a higher risk of symptom worsening (OR [95% CI] = 1.4 [1.0-1.8], p = 0.034 and OR [95% CI] = 2.1 [1.2-3.7], p = 0.01, respectively).

Conclusion

NMS progression over the disease course in PD shows large inter-individual variability without observable effect of sex.

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来源期刊

Neurologia 医学-临床神经学

CiteScore

5.90

自引率

2.60%

发文量

135

审稿时长

48 days

期刊介绍： Neurología es la revista oficial de la Sociedad Española de Neurología y publica, desde 1986 contribuciones científicas en el campo de la neurología clínica y experimental. Los contenidos de Neurología abarcan desde la neuroepidemiología, la clínica neurológica, la gestión y asistencia neurológica y la terapéutica, a la investigación básica en neurociencias aplicada a la neurología. Las áreas temáticas de la revistas incluyen la neurologia infantil, la neuropsicología, la neurorehabilitación y la neurogeriatría. Los artículos publicados en Neurología siguen un proceso de revisión por doble ciego a fin de que los trabajos sean seleccionados atendiendo a su calidad, originalidad e interés y así estén sometidos a un proceso de mejora. El formato de artículos incluye Editoriales, Originales, Revisiones y Cartas al Editor, Neurología es el vehículo de información científica de reconocida calidad en profesionales interesados en la neurología que utilizan el español, como demuestra su inclusión en los más prestigiosos y selectivos índices bibliográficos del mundo.