摘要: |
目的:调查伴临床可疑快速眼动期睡眠行为障碍(clinical possible rapid eye movement sleep behavior disorder, cpRBD)的帕金森病(Parkinson disease, PD)患者的临床表型特征,探讨其相关影响因素。
方法:运用德国版RBD筛查量表(RBDSQ)及相关神经心理学评估量表,调查110例中国PD患者cpRBD的发生情况及与患者人口学资料,运动症状,非运动症状(嗅觉减退、抑郁症状、便秘、自主神经功能、认知功能等)及主要运动并发症(剂末现象、异动症)间的相关性。
结果:40例(36.4%)PD患者伴发cpRBD。与不伴cpRBD的PD患者相比,伴cpRBD的PD患者中男性更多,非运动症状问卷筛查量表(NMSQ)评分及PD自主神经症状量表(SCOPA-AUT)评分更高,嗅觉减退、慢性便秘及抑郁症状比例更高,差异均有统计学意义(P<0.05);两组患者运动症状的严重程度、运动亚型及主要运动并发症比例差异无统计学意义。多因素logistic回归分析提示,男性(OR=3.541, 95%CI 1.269~9.877, P=0.016)、抑郁症状(OR=5.365, 95%CI 1.161~11.470, P=0.027)、高SCOPA-AUT评分(OR=1.098, 95%CI 1.005~1.200,P=0.038)是PD患者伴发cpRBD的独立相关因素。
结论:伴发cpRBD的PD患者以男性多见,非运动症状受累更严重。抑郁症状和严重的自主神经功能受累与PD患者RBD的发生密切相关。 |
关键词: 帕金森病 快速眼动期睡眠行为障碍 非运动症状 抑郁 自主神经功能受累 |
DOI: |
分类号:R 742.5 |
基金项目:上海市青年科技英才扬帆计划(18YF1412600),上海市浦江人才计划(18PJD023),上海交通大学医工交叉项目(YG2017QN13). |
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Clinical phenotypic characteristics of patients with Parkinson disease with suspicious rapid eye movement sleep behavior disorder |
WU Li, HE Qing, ZHAO Lei, JIANG Chun-yan, CHEN Wei*, DONG You-rong*, LIU Jian-ren
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Department of Neurology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
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Abstract: |
Objective:To investigate the clinical phenotypic characteristics of patients with Parkinson disease (PD) with suspicious rapid eye movement sleep behavior disorder (cpRBD) and its related factors.
Methods:The German version of the RBD screening scale (RBDSQ) and related neuropsychological assessment scales were used to investigate the incidence of cpRBD in 110 Chinese patients with PD. The association between the incidence of cpRBD and demographic data, motor symptoms, non-motor symptoms (hyposmia, depression, constipation, autonomic and cognitive function assessment, etc), and major motor complications (wearing-off and dyskinesia) were analyzed.
Results:A total of 40 PD patients were complicated with cpRBD, accounting for 36.4%. Compared with PD patients without cpRBD, PD patients with cpRBD had higher scores in the non-motor symptoms questionnaire (NMSQ) and the scale for outcomes in PD for autonomic symptoms (SCOPA-AUT), and higher proportions of males, hyposmia, constipation, and depressive symptoms (P<0.05). There was no statistical difference regarding the severity of motor symptoms, the subtype of motor symptoms, and the proportion of major motor complications between the two groups. Multivariate logistic regression analysis showed that male (OR=3.541, 95%CI 1.269-9.877, P=0.016), depressive symptoms (OR=5.365, 95%CI 1.161-11.470, P=0.027), and high SCOPA-AUT score (OR=1.098, 95%CI 1.005-1.200, P=0.038) were independent factors for cpRBD in PD patients.
Conclusions:PD patients with cpRBD are more common in males, and those with more serious non-motor symptoms, depression and severe autonomic dysfunction may increase the occurrence of RBD in PD patients. |
Key words: Parkinson disease rapid eye movement sleep behavior disorder non-motor symptoms depression autonomic dysfunction |