Predictors for mild parkinsonian signs: A prospective population-based study
Predictors for mild parkinsonian signs: A prospective population-based study
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DOI：
10.1016/j.parkreldis.2014.12.021
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发表时间：
2015-03-01
影响因子：
4.1
通讯作者：
Seppi, Klaus
中科院分区：
文献类型：
--
作者：
Mahlknecht, Philipp;Kiechl, Stefan;Seppi, Klaus
目的：轻度帕金森症状（MPS）在老年人群中很常见，并与多种不良健康结局相关，包括帕金森病（PD）的发生。我们的目的是前瞻性地评估MPS事件的潜在危险因素。方法：以人群为基础的Bruneck研究代表了一般老年人社区的参与者，他们接受了经颅超声黑质（SN）回声性的基线评估，嗅嗅棒识别试验的嗅觉功能评估，根据Framingham风险评分的血管风险评估，以及基线和5年随访神经学检查。MPS是根据统一PD评定量表的整个运动部分的既定标准来定义的。排除基线时患有PD或随访的受试者以及基线时患有MPS的受试者。在剩余的393名参与者中，采用调整年龄和性别的logistic回归分析来检测MPS事件的危险因素。结果：sn -高回声和低回声与MPS的发生相关，比值比分别为2.0 （95%CI, 1.1-3.7）和1.6 (95%CI, 1.0-2.7)，而血管风险增加与MPS无关。同时具有sn高回声和低回声，与MPS事件的比值比为3.0 （95%CI,12-7.7）相关。在不同的运动域中，sn回声增强预示着运动迟缓和僵硬的发展，而嗅觉功能减弱预示着轴向运动功能受损的发展。结论：除了作为PD危险因素的既定作用外，sn -高回声性和低回声性与一般老年人MPS风险增加有关。(C) 2015 Elsevier Ltd.版权所有。
Objective: Mild parkinsonian signs (MPS) are common in the elderly population and are associated with a wide range of adverse health outcomes, including incident Parkinson's disease (PD). We aimed to prospectively evaluate potential risk factors for incident MPS.Methods: Participants of the population-based Bruneck Study representative for the general elderly community underwent a baseline assessment of substantia nigra (SN)-echogenicity with transcranial sonography, olfactory function with the Sniffin' Sticks identification test and vascular risk according to the Framingham risk score as well as a baseline and 5-year follow-up neurological examination. MPS were defined according to established criteria based on the entire motor section of the Unified PD Rating Scale. Participants with PD at baseline or follow-up and subjects with MPS at baseline were excluded. A logistic regression analysis adjusted for age and sex was used to detect risk factors for incident MPS in the remaining 393 participants.Results: SN-hyperechogenicity and hyposmia were related to the development of MPS with odds ratios of 2.0 (95%CI, 1.1-3.7) and 1.6 (95%CI, 1.0-2.7), respectively, while increased vascular risk was not. Having both, SN-hyperechogenicity and hyposmia, was associated with an odds ratio of 3.0 (95%CI,12-7.7) for incident MPS. Among the various motor domains, increased SN-echogenicity predicted the development of bradykinesia and rigidity, whereas diminished olfactory function predicted the development of impaired axial motor function.Conclusions: In addition to their established roles as risk factors for PD, SN-hyperechogenicity and hyposmia are associated with an increased risk for MPS in the general elderly community. (C) 2015 Elsevier Ltd. All rights reserved.