Vascular disease and vascular risk factors in relation to motor features and cognition in early Parkinson's disease.
Vascular disease and vascular risk factors in relation to motor features and cognition in early Parkinson's disease.
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DOI：
10.1002/mds.26698
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发表时间：
2016-10
影响因子：
8.6
通讯作者：
Grosset, Donald G.
中科院分区：
文献类型：
--
作者：
Malek, Naveed;Lawton, Michael A.;Swallow, Diane M. A.;Grosset, Katherine A.;Marrinan, Sarah L.;Bajaj, Nin;Barker, Roger A.;Burn, David J.;Hardy, John;Morris, Huw R.;Williams, Nigel M.;Wood, Nicholas;Ben-Shlomo, Yoav;Grosset, Donald G.
本研究的目的是探讨帕金森病(PD)患者的血管疾病(和血管危险因素)、认知和运动表型之间的关系。最近确诊的帕金森病患者参加了一项多中心前瞻性纵向队列研究。分析蒙特利尔认知评估(正常23分，轻度认知损害22~23分或以下但无功能损害，痴呆21分或以下伴功能损害)和运动障碍协会统一PD评定量表第三部分(UPDRS 3)评分与血管事件史和危险因素的关系。在1759例PD患者中，平均年龄67.5(标准差9.3)年，平均病程1.3(标准差0.9)年，男性占65.2%，有中风或短暂性脑缺血发作病史的占4.7%，有心脏病(心绞痛、心肌梗死、心力衰竭)的占12.5%。在无血管病史的患者中，高血压占30.4%，高胆固醇占27.3%，肥胖占20.7%，糖尿病占7.2%，吸烟占4.6%。既往有中风或短暂性脑缺血发作的患者更有可能出现认知障碍(42%比25%)和姿势不稳定步态困难(53.5%比39.5%)，但在调整年龄、性别和病程后，这些结果并不显著(P=0.075)。存在2个以上血管风险与较差的UPDRS 3运动评分(β系数4.05，95%可信区间1.48，6.61，p=0.002)和认知损害(序数优势比2.24，95%可信区间1.34，3.74，p=0.002)相关。在842例(47.8%)脑结构成像患者中，白质白质疏松与认知损害(p=.006)和姿势不稳定步态困难(p=.010)有关，而与腔隙或脑梗塞无关。血管共病与早期帕金森病患者的认知和步态障碍显著相关，这可能具有预后和治疗意义。©2016作者。《运动障碍》由威利期刊公司代表国际帕金森和运动障碍协会出版。
The purpose of this study was to examine the relationship between vascular disease (and vascular risk factors), cognition and motor phenotype in Parkinson's disease (PD). Recently diagnosed PD cases were enrolled in a multicenter prospective observational longitudinal cohort study. Montreal cognitive assessment (normal >23, mild cognitive impairment 22 to 23 or lower but without functional impairment, and dementia 21 or less with functional impairment) and Movement Disorder Society Unified PD Rating Scale part 3 (UPDRS 3) scores were analyzed in relation to a history of vascular events and risk factors. In 1759 PD cases, mean age 67.5 (standard deviation 9.3) years, mean disease duration 1.3 (standard deviation 0.9) years, 65.2% were men, 4.7% had a history of prior stroke or transient ischemic attack, and 12.5% had cardiac disease (angina, myocardial infarction, heart failure). In cases without a history of vascular disease, hypertension was recorded in 30.4%, high cholesterol 27.3%, obesity 20.7%, diabetes 7.2%, and cigarette smoking in 4.6%. Patients with prior stroke or transient ischemic attack were more likely to have cognitive impairment (42% vs 25%) and postural instability gait difficulty (53.5% vs 39.5%), but these findings were not significant after adjustment for age, sex, and disease duration (P = .075). The presence of more than 2 vascular risks was associated with worse UPDRS 3 motor scores (beta coefficient 4.05, 95% confidence interval 1.48, 6.61, p = .002) and with cognitive impairment (ordinal odds ratio 2.24, 95% confidence interval 1.34, 3.74, p = .002). In 842 patients (47.8%) with structural brain imaging, white matter leukoaraiosis, but not lacunar or territorial infarction, was associated with impaired cognition (p = .006) and postural instability gait difficulty (p = .010). Vascular comorbidity is significantly associated with cognitive and gait impairment in patients with early PD, which may have prognostic and treatment implications. © 2016 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.
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影响因子：
37.8
作者：
Hajjar I;Quach L;Yang F;Chaves PH;Newman AB;Mukamal K;Longstreth W Jr;Inzitari M;Lipsitz LA
通讯作者：
Lipsitz LA
影响因子：
4.1
作者：
Kotagal V;Albin RL;Müller ML;Koeppe RA;Frey KA;Bohnen NI
通讯作者：
Bohnen NI
DOI：
10.1016/j.jstrokecerebrovasdis.2014.05.008
发表时间：
2014-08-01
影响因子：
2.5
作者：
Hashimoto, Manabu;Takashima, Yuki;Yao, Hiroshi
通讯作者：
Yao, Hiroshi
影响因子：
6.4
作者：
Guan, Jian;Pavlovic, Darja;Nicholson, Louise F. B.
通讯作者：
Nicholson, Louise F. B.
影响因子：
5.1
作者：
Gonzalez-Redondo, R.;Toledo, J.;Rodriguez-Oroz, M. C.
通讯作者：
Rodriguez-Oroz, M. C.