Meta-analyses on prevalence of selected Parkinson's nonmotor symptoms before and after diagnosis.
Meta-analyses on prevalence of selected Parkinson's nonmotor symptoms before and after diagnosis.
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DOI：
10.1186/2047-9158-4-1
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发表时间：
2015
影响因子：
12.6
通讯作者：
Peddada S
中科院分区：
文献类型：
--
作者：
Chen H;Zhao EJ;Zhang W;Lu Y;Liu R;Huang X;Ciesielski-Jones AJ;Justice MA;Cousins DS;Peddada S
非运动症状在帕金森病（PD）患者中很常见，有些可能先于疾病诊断。我们使用随机效应模型对PD诊断前后选定的非运动症状的患病率进行了荟萃分析。我们在PubMed（1965年至2012年10月/11月）中检索了以下症状：嗅觉减退、便秘、快速眼动睡眠行为障碍、白天过度嗜睡、抑郁和焦虑。合格的研究是英文出版物，其中有一种或多种症状的原始数据。检索产生了2，373篇非重复出版物，332篇符合纳入标准，大多数（n = 320）是关于PD诊断后的症状。对于所有症状，患病率在PD病例中显著高于对照组，每种都影响超过三分之一的患者。嗅觉减退是最普遍的（病例组为75.5%，对照组为19.1%），其次是便秘（50% vs. 17.7%），焦虑（39.9% vs.19.1%）、快动眼睡眠行为障碍（37.0% vs. 7.0%）、抑郁（36.6% vs. 14.9%）和白天过度嗜睡（33.9% vs. 10.5%）。我们观察到大量的异质性研究和荟萃回归分析表明，几个因素可能促成了这一点。然而，在几项敏感性分析中，患病率估计值相当稳健。只有20项研究在PD诊断前有任何症状的数据，但分析仍然显示未来PD病例的患病率高于对照组。这些症状在PD患者诊断前后都很常见。需要进一步的研究来了解PD非运动症状的自然史及其病因学和临床意义。本文的在线版本（doi：10.1186/2047-9158-4-1）包含补充材料，可供授权用户使用。
Nonmotor symptoms are common among patients with Parkinson’s disease (PD) and some may precede disease diagnosis. We conducted a meta-analysis on the prevalence of selected nonmotor symptoms before and after PD diagnosis, using random-effect models. We searched PubMed (1965 through October/November 2012) for the following symptoms: hyposmia, constipation, rapid eye movement sleep behavior disorder, excessive daytime sleepiness, depression, and anxiety. Eligible studies were publications in English with original data on one or more of these symptoms. The search generated 2,373 non-duplicated publications and 332 met the inclusion criteria, mostly (n = 320) on symptoms after PD diagnosis. For all symptoms, the prevalence was substantially higher in PD cases than in controls, each affecting over a third of the patients. Hyposmia was the most prevalent (75.5% in cases vs. 19.1% in controls), followed by constipation (50% vs. 17.7%), anxiety (39.9% vs. 19.1%), rapid eye movement sleep behavior disorder (37.0% vs. 7.0%), depression (36.6% vs. 14.9%), and excessive daytime sleepiness (33.9% vs. 10.5%). We observed substantial heterogeneities across studies and meta-regression analyses suggested that several factors might have contributed to this. However, the prevalence estimates were fairly robust in several sensitivity analyses. Only 20 studies had data on any symptoms prior to PD diagnosis, but still the analyses revealed higher prevalence in future PD cases than in controls. These symptoms are common among PD patients both before and after diagnosis. Further studies are needed to understand the natural history of nonmotor symptoms in PD and their etiological and clinical implications. The online version of this article (doi:10.1186/2047-9158-4-1) contains supplementary material, which is available to authorized users.
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